进行性出血性脑损伤病灶体积变化对手术治疗的影响

目的分析颅脑外伤后进行性出血性脑损伤(Progressive Hemorrhagic Injury,PHI)患者病灶体积变化对于手术治疗的影响。方法 PHI患者共4 8例,分为手术组(n=3 2)与非手术组(n=1 6)例,比较两组入院时格拉斯哥评分(GCS),年龄,六个月GOS,首次CT损伤灶体积以及伤后2 4小时内损伤灶体积变化。采用独立样本t检验比较两组数据的差异;采用Logistic回归分析手术治疗的影响因素。结果首次CT损伤灶体积与伤后2 4小时内损伤灶体积变化,六个月GOS的差异有统计学意义(P<0.0 5),入院时格拉斯哥评分(GCS),年龄的差异没有统计学意义(P>0.0 5),伤后2 4小时内损伤灶体积变化(增大)是手术治疗的高危因素(OR 5.9 6 0,P<0.0 5)。结论对于颅脑外伤后进行性出血性脑损伤(PHI)患者,伤后2 4小时内损伤灶体积增长速度越快,需要手术治疗的风险就越大,手术治疗患者六个月GOS较非手术患者差。

Effection of variation of lesion volume to operation on progressive hemorrhagic injury in traumatic brain injury

Objective To analyse the effection of variation of lesion volume to operation on progressive hemorrhagic injury in traumatic brain injury.Methods 48 patients with progressive hemorrhagic injury were analyzed in the retrospective study,who were divided into operation group(n=32)and non-operation(n=16).Age,Glasgow come score(GCS)at presentation,6-month Glasgow outcome score(GOS),lesion volume in first CT scan and its variation whitin 24 hours after injury were compared between groups.T-test was used to compare the difference between groups.Logistic regression analysis was conducted to analysis the risk factors of surgery.Results There were significant difference in 6-month GOS score,lesion volume in first CT scan and its variation whitin 24 hours after injury(P<0.05)between the two groups,while not in age and GCS at presentation(P>0.05).Logistic regression analysis revealed that lesion volume whitin 24 hours after injury was High-Risk Factor for operation(OR 5.960,P<0.05).Conclusions To patients with PHI,the faster growth of lesion volume whitin 24 hours after injury,the more likely to undergo operation.The 6-month GOS score in operation group were worse than the other.