[1]倪　萌　高　山　桂世涛　周子扬　季　晶.去骨板减压术治疗的重型颅脑损伤出院时预后的影响因素[J].中国临床神经外科杂志,2020,(03):147-148.[doi:10.13798/j.issn.1009-153X.2020.03.006]
　NI Meng,GAO Shan,GUI Shi-tao,et al.Risk factors of prognosis at discharge in patients with severe traumatic brain injury after decompressive craniectomy[J].,2020,(03):147-148.[doi:10.13798/j.issn.1009-153X.2020.03.006]
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去骨板减压术治疗的重型颅脑损伤出院时预后的影响因素()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2020年03期
页码:
147-148
栏目:
论著
出版日期:
2020-03-31

文章信息/Info

Title:
Risk factors of prognosis at discharge in patients with severe traumatic brain injury after decompressive craniectomy
文章编号:
1009-153X（2020）03-0147-02
作者:
倪　萌　高　山　桂世涛　周子扬　季　晶
215129 江苏，苏州市高新区人民医院神经外科（倪　萌、高　山、桂世涛、周子扬）；210000 南京，南京医科大学第一临床医学院（季　晶） （2019-07-17收稿，2019-10-29修回）
Author(s):
NI Meng1;  GAO Shan1;  GUI Shi-tao1;  ZHOU Zi-yang1;  JI Jing2.
1. Department of Neurosurgery, People's Hospital of Suzhou High-tech Zone, Suzhou 215129, China; 2. The First Clinical Medical College of Nanjing Medical University, Nanjing 210000, China
关键词:
重型颅脑损伤; 去骨瓣减压术; 早期预后; 影响因素
Keywords:
Severe traumatic brain injury;  Decompressive craniectomy;  Early prognosis;  Influencing factors
分类号:
R 651.1+5; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2020.03.006
文献标志码:
A
摘要:
目的 探讨重型颅脑损伤去骨瓣减压术后出院时预后的影响因素。方法 回顾性分析2014年5月至2019年5月收治的150例重型颅脑损伤的临床资料，均行去骨板减压术治疗。出院时，根据GOS评分评估预后，4~5分为预后良好，1~3分为预后不良。采用多因素logistic回归分析检验预后影响因素。结果 150例中，出院时预后良好39例，预后不良111例。多因素logistic回归分析结果显示，入院时APACHEⅡ评分低、无瞳孔散大及入院时GCS评分较高及气管切开术是预后良好的独立评估指标（P<0.05）。结论 重型颅脑损伤病人预后影响因素很多，对于入院时APACHEⅡ评分较高、瞳孔散大、入院GCS评分较低的病人，应及早采取措施干预，以改善病人预后；另外，重型颅脑损伤建议尽早进行气管切开术
Abstract:
Objective To investigate the risk factors of prognosis at discharge in patients with severe traumatic brain injury (sTBI) after decompressive craniectomy. Methods The clinical data of 150 patients with sTBI who underwent decompression from May, 2014 to May, 2019 were retrospectively analyzed. At discharge, the prognosis was evaluated according to the GOS score, with 4 to 5 being a good prognosis and 1 to 3 being a poor prognosis. The risk factors were analyzed by multivariate logistic regression analysis. Results Of 150 patients, 39 patients had good prognosis and 111 patients had poor prognosis at discharge. Multivariate logistic regression analysis showed that low APACHEⅡ score at admission, no pupil dilatation, high GCS score at admission, and tracheostomy were independent indicators of good prognosis (P<0.05). Conclusion There are many factors affecting the prognosis of patients with sTBI. For patients with high APACHEⅡ score, dilated pupils, and low GCS score at admission, early intervention should be taken to improve the patient's prognosis. In addition, it is recommended that the tracheotomy should be performed in the patients with sTBI as early as possible.

参考文献/References:

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备注/Memo

备注/Memo:
基金项目：国家自然科学基金（81471269）
更新日期/Last Update: 2020-03-10