脑外伤后进展性出血性损伤的影响因素分析

目的 探讨脑外伤后进展性出血性损伤(PHI)发生的影响因素.方法 回顾性分析127例颅脑损伤患者(PHI组49例,非PHI组78例)的临床资料,比较不同性别、年龄、格拉斯哥昏迷计分、伤后首次头颅CT检查时间、创伤性蛛网膜下腔出血(tSAH)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)等因素对PHI发生的影响.结果 PHI组首次CT时间(1.39±1.27)h,非PHI组(2.91±1.85)h,2组比较差异有统计学意义(t=2.14,P<0.05).PHI组发生tSAH 35例,非PHI组发生37例,2组tSAH发生率差异有统计学意义(χ2=7.06,P<0.05).多因素Logistic回归分析结果表明,伤后首次行头颅CT检查的时间以及伴有tSAH与脑外伤后PHI的发生有密切关系(OR值0.558,95%CI 0.329～0.946,OR值13.000,95%CI1.187～142.354,P均<0.05).结论 颅脑损伤后首次CT检查的时间以及tSAH可以作为PHI发生的预判指标.

Analysis of the influencing factors of pragressive hemorrhagic injury after traumatic brain Injury

Objective To investigate the influencing factors of progressive hemorrhagic injury (PHI) after traumatic brain injury. Methods The medical records of 127 patients with traumatic brain injury (n=49 in PHI group and n=78 in non-PHI group) were reviewed. The relationship between PHI and influencing factors including sex, age, Glasgow coma scale, time from injury to first CT, traumatic subaraehnoid hemorrhage (tSAH), prothrombin time(PT),activated partial thromboplastin time(APTT) was analyzed. Results The time for first CT was(1.39± 1.27) h in PHI group and (2.91±1.85) h in non-PHI group (t=2.14, P<0.05). 35 cases of PHI group developed tSAH and 37 of non-PHI group developed tSAH (χ2=7.06, P<0.05). Multifactor Logistic regression analysis showed that the time for first brain CT after injury and the patients accompanied with tSAH were associated with PHI after traumatic brain injury (OR=0.558,95 % CI 0.329-0.946, OR=13.000,95 % CI 1.187-142.354, P<0.05 for each). Conclusions Time from injury to first CT and tSAH can be prognostic factors for PHI.