颅脑损伤后上消化道出血危险因素分析

目的 分析颅脑损伤后上消化道出血的主要危险因素。方法 回顾性分析80例颅脑损伤患者的临床资料,对合并上消化道出血的高危因素进行分析。结果 80例颅脑损伤患者发生急性上消化道出血39例(48.8％),死亡26例,其中伴上消化道出血组死亡21例(53.8％),不伴有上消化道出血组死亡5例(19.2％)。在影响颅脑损伤后上消化道出血的相关因素中,上消化道出血的发生与患者格拉斯哥昏迷量表(GCS)评分、败血症、去大脑强直、低血压、代谢性酸中毒和高血糖水平呈显著相关(x2 =13.96,x2=27.43,x2=46.28,x2=27.33,x2=11.88,x2=5.71,P＜0.05或P＜0.01)。结论 在颅脑损伤的监护治疗中,应尽早干预上消化道出血的相关危险因素,降低消化道出血的发生,可改善颅脑损伤患者预后,降低病死率。

The risk factors analysis for upper gastrointestinal bleeding after craniocerebral trauma

Objective To explore the risk factors for upper gastrointestinal bleeding after craniocerebral trauma.Methods To retrospectively summarize the clinical features of 80 cases with craniocerebral truma and to analyze the risk factors for upper gastrointestinal bleeding.Results Upper gastrointestinal bleeding was present in 39 of the 80 cases(48.8％) .Twenty-one of the 39 cases with gastrointestinal bleeding died(53.8％) In the patients without gastrointestinal bleeding, 5 cases died (19.2％) .Among the factors affecting the gastrointestinal bleeding after craniocerebral trauma, Glasgow Coma Scale(GCS) score, septicemia, decerebration,hypotention, metabolic acidosis and hyperglucose were closely related risk factors(x2 = 13.96;x2 = 27.43;x2 =46.28 ;x2 = 27.33 ;x2 = 11.88 ;x2 =5.71 ,P ＜0.05 or P ＜0.01).Conclusion Prophylaxis against related risk factors could reduce the incidence of gastrointestinal bleeding, improve the prognosis and decrease the mortality of craniocerebral trauma.