[1]李　勇　姜永亮　黄　波.颅脑损伤后动、静脉性脑梗死的相关危险因素分析[J].中国临床神经外科杂志,2015,(05):284-286,289.[doi:10.13798/j.issn.1009-153X.2015.05.009]
　LI Yong,JIANG Yong-liang,HUANG Bo..Risk factors related to traumatic arterial and venous cerebral infarction after craniocerebral trauma[J].,2015,(05):284-286,289.[doi:10.13798/j.issn.1009-153X.2015.05.009]
点击复制

颅脑损伤后动、静脉性脑梗死的相关危险因素分析()
分享到：

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2015年05期
页码:
284-286,289
栏目:
论著
出版日期:
2015-05-30

文章信息/Info

Title:
Risk factors related to traumatic arterial and venous cerebral infarction after craniocerebral trauma
文章编号:
1009-153X（2015）05-0284-03
作者:
李　勇　姜永亮　黄　波
201600，上海市松江区中心医院神经外科
Author(s):
LI Yong;  JIANG Yong-liang;  HUANG Bo.
Department of Neurosurgery, Central Hospital of Songjiang District, Shanghai 201600, China
关键词:
颅脑损伤; 脑梗死; 动脉; 静脉; 危险因素
Keywords:
Traumatic brain injury;  Artery ; Vein;  Cerebral infarction;  Risk factors
分类号:
R 651.1+5
DOI:
10.13798/j.issn.1009-153X.2015.05.009
文献标志码:
A
摘要:
目的 探讨颅脑损伤继发动脉性脑梗死、静脉性脑梗死的危险因素。方法 回顾性分析我院2012年4月~2014年7月收治的169例中、重型颅脑损伤患者的临床资料，采用单因素分析和Logistic回归分析颅脑损伤继发动脉性脑梗死、静脉性脑梗死的可能危险因素。结果 单因素分析发现年龄≥60岁、瞳孔散大、中线移位≥10 mm、环池消失、入院时GCS评分≤8分、合并伤以及低血压是动脉性梗死的危险因素（P<0.05）；而合并伤、大脑浅静脉损伤及D-二聚体增高是静脉性脑梗死的危险因素（P<0.05）。Logistic回归分析发现，低血压（优势比为3.054；95%可信区间为1.168~3.893；P=0.017）和瞳孔散大（优势比为5.752；95%可信区间为1.035~7.723；P=0.003）是动脉性脑梗死的独立危险因素，大脑浅静脉损伤（优势比为5.827；95%可信区间为1.507~6.384；P=0.002）是静脉性脑梗死的独立危险因素。结论 在防治颅脑损伤后动脉性脑梗死或静脉性脑梗死时，脑疝、颅内压、低血压及大脑浅静脉损伤应加强干预。
Abstract:
Objective To investigate the risk factors related to the traumatic arterial and venous cerebral infarction after the craniocerebral trauma. Methods The clinical data of 169 patients with middle or severe craniocerebral trauma treated in our hospital from April, 2012 to July, 2014, were analyzed retrospectively. The risk factors related to the arterial and venous cerebral infarction after craniocerebral trauma were analyzed by univariate and multivariate Logistic regression analysis. Results The arterial cerebral infarction occurred in 42 and the venous cerebral infarction occurred in 59 of 169 patients with middle or severe craniocerebral trauma. The univariate analysis showed that the risk factors related to the arterial cerebral infarction included, age ≥60 years, mydriasis, cerebral midline shift ≥ 10 mm, disappearance of ambient cistern, GCS ≤8 points, associated injuries and hypotension (P<0.05), and the factors related to the venous cerebral infarction included associated-injuries, superficial cerebral veins injury and increase in the D-dimer value (P<0.05). The multivariate Logistic regression analysis showed that hypotension and mydriasis were the independent risk factors of the arterial cerebral infarction (P<0.05), and superficial cerebral veins injury was the independent risk factors of venous cerebral infarction (P<0.05). Conclusion Hypotension and mydriasis, which are the independent risk factors of the arterial cerebral infarction, and superficial cerebral veins injury, which is the independent risk factors of venous cerebral infarction, should be positively treated in order to prevent the cerebral infarction after the craniocerebral injury.

参考文献/References:

[1] 刘企源，许文辉. 颅脑损伤患者开颅术后颅内再出血的相 关因素分析[J]. 中华神经外科杂志，2013，29（2）：134- 137.
[2] 徐　震，黄李法，吕晓皑，等. 大骨瓣减压对不同年龄重型 颅脑损伤患者脑血流量及脑代谢的影响[J]. 中华神经外 科杂志，2011，27（1）：62-64.
[3] 龙连圣，辛志成，王伟明，等. 中、重型颅脑损伤并发创伤 性脑梗死的多因素分析[J]. 中华创伤杂志，2011，27 （10）：881-885.
[4] 兰红琳，孙慧苗. 静脉性脑梗死的磁共振成像诊断[J]. 中 国药物与临床，2011，11（1）：17-18.
[5] 徐有学，孙立华，林秋全，等. 手术时间窗对外伤性脑疝术 后脑梗死发病率的影响[J]. 贵阳中医学院学报，2012，34 （4）：98-100.
[6] 陈　磊，王玉海，蔡学见，等. 重型、特重型颅脑外伤性脑 梗死相关危险因素分析[J]. 中华神经外科杂志，2011，27 （4）：387-390.
[7] 林秋全，王洪峰，刘同义，等. 多层螺旋CT在脑疝术后脑 梗死中的诊断价值[J]. 贵阳中医学院学报，2012，34（4）： 58-59.
[8] 施栋良，董吉荣，蔡学见，等. 术中颅内压监测在治疗重型 颅脑损伤中的应用[J]. 中华神经外科杂志，2012，28（2）： 116-118.
[9] 张　赛，涂　悦，赵明亮，等. 大骨瓣减压术治疗颅脑损伤 后顽固性高颅压[J]. 中华神经外科杂志，2011，27（2）： 169-173.
[10] 惠纪元，龚　如，梁玉敏，等. 中国颅脑损伤数据库：短期 预后因素分析[J].中华神经外科杂志，2014，30（1）：56- 58.

相似文献/References:

[1]张善纲 综述.现代战争中颅脑损伤的特点及功能康复[J].中国临床神经外科杂志,2015,(11):701.[doi:10.13798/j.issn.1009-153X.2015.11.021]
[2]钟秀均　黄书岚.复方醒脑液治疗颅脑损伤后综合征的临床观察[J].中国临床神经外科杂志,2016,(05):278.[doi:10.13798/j.issn.1009-153X.2016.05.007]
　ZHONG Xiu-jun,HUANG Shu-lan..Clinical observation on treatment of compound decoction for cerebral prorection for post-traumatic brain syndrome[J].,2016,(05):278.[doi:10.13798/j.issn.1009-153X.2016.05.007]
[3]李国亮　邸　方　杨亚东.香芹酚通过抑制脑水肿与氧化应激反应保护大鼠 颅脑损伤[J].中国临床神经外科杂志,2016,(05):283.[doi:10.13798/j.issn.1009-153X.2016.05.009]
　LI Guo-liang,DI Fang,YANG Ya-dong..Carvacrol protects against traumatic brain injury in rats through suppressing the brain edma and oxidative stress[J].,2016,(05):283.[doi:10.13798/j.issn.1009-153X.2016.05.009]
[4]罗心凯　陈治标　陈谦学.免缝胶原海绵人工硬脑膜在颅脑损伤大骨瓣减压术中的应用[J].中国临床神经外科杂志,2016,(06):357.[doi:10.13798/j.issn.1009-153X.2016.06.012]
　LUO Xin-kai,CHEN Zhi-biao,CHEN Qian-xue..Application of collagen sponge artificial dura without suturing to big bone flap decompression after traumatic brain injury[J].,2016,(05):357.[doi:10.13798/j.issn.1009-153X.2016.06.012]
[5]贺瑛福　肖宗宇　马进海　许常林　裴　杰　袁　岗　张广华　 巨　虎.高海拔地区重型颅脑损伤血清FSH、LH、PRL的变化[J].中国临床神经外科杂志,2016,(06):359.[doi:10.13798/j.issn.1009-153X.2016.06.013]
　HE Ying-fu,XIAO Zong-yu,MA Jin-hai,et al.Changes in serum FSH, LH and PRL levels in the patients with severe traumatic brain injury in plateau[J].,2016,(05):359.[doi:10.13798/j.issn.1009-153X.2016.06.013]
[6]满明昊　李立宏　杨彦龙　李　敏　郭少春.颅脑损伤术后细胞免疫指标变化及脾多肽对其影响[J].中国临床神经外科杂志,2016,(06):362.[doi:10.13798/j.issn.1009-153X.2016.06.014]
　MAN Ming-hao,LI Li-hong,YANG Yan-yong,et al.Changes in peripheral cells immunity after operation and effect of spleen polypeptide on them in patients with traumatic brain injury[J].,2016,(05):362.[doi:10.13798/j.issn.1009-153X.2016.06.014]
[7]肖连福　黄瑞宏　陈昌勇　周希汉　黄陈铭　林进平　李文生.标准大骨瓣减压术联合硬脑膜翻转及颞肌贴敷治疗 大面积脑梗死35例[J].中国临床神经外科杂志,2016,(06):370.[doi:10.13798/j.issn.1009-153X.2016.06.017]
[8]程　勇　秦加新　戢翰升　李　刚　聂劲林　李　强.颅脑损伤术中急性脑膨出的相关因素分析[J].中国临床神经外科杂志,2016,(06):374.[doi:10.13798/j.issn.1009-153X.2016.06.019]
[9]张一帆 综述　张国来 审校.弥漫性轴索损伤影像学诊断的研究进展[J].中国临床神经外科杂志,2016,(07):442.[doi:10.13798/j.issn.1009-153X.2016.07.020]
[10]高　麟　麻晓融　董宇峰　李海龙.高血压脑出血术后脑梗死的原因及防治[J].中国临床神经外科杂志,2016,(07):445.[doi:10.13798/j.issn.1009-153X.2016.07.022]
[11]屈晓东　季　玮　周　杰　荔志云.小儿颅脑损伤后并发大面积脑梗死1例[J].中国临床神经外科杂志,2018,(02):142.

更新日期/Last Update: 2015-05-30