外伤性颅内血肿术后不良预后的危险因素

目的 探讨外伤性颅内血肿术后预后不良的危险因素。方法 回顾性分析2016年4月至2019年3月手术治疗的228例外伤性颅内血肿的临床资料。伤后6个月采用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回归分析检验预后不良危险因素；采用受试者工作特征（ROC）曲线分析分析影响因素的评估效能。结果 228例中，158例预后良好，70例预后不良。多因素logistic回归分析示，术前GCS评分低、血肿量大、改良CT评分高、部分活化凝血活酶时间（APTT）延长是预后不良的独立影响因素（P<0.05）。ROC曲线分析显示，术前GCS评分、血肿量、改良CT评分、APTT评估预后不良的曲线下面积（AUC）分别为0.790、0.824、0.826、0.617，四个指标联合评估预后不良的AUC为0.954。结论 术前GCS评分、血肿量、改良CT评分、APTT对外伤性颅内血肿术后预后不良有一定的评估价值，联合评估效果更好

Risk factors for postoperative poor prognosis in patients with traumatic intracranial hematoma

Objective To explore the risk factors for postoperative poor prognosis in the patients with traumatic intracranial hematoma. Methods The clinical data of 228 patients with traumatic intracranial hematoma who underwent surgery from April 2016 to March 2019 were analyzed retrospectively. Six months after injury, the GOS score was used to evaluate the prognosis, with good prognosis of 4~5 points and poor prognosis of 1~3 points. The risk factors of prognosis was analyzed by multivariate logistic regression analysis. Results Of 228 patients, 158 patients had a good prognosis and 70 had a poor prognosis. Multivariate logistic regression analysis showed that low preoperative GCS score, large hematoma, high modified CT score, and prolonged partially activated thromboplastin time (APTT) were independent risk factors for poor prognosis (P<0.05). ROC curve analysis showed that the area under the curve (AUC) of the preoperative GCS score, hematoma volume, modified CT score, and APTT for poor prognosis assessment were 0.790, 0.824, 0.826, and 0.617, respectively, and the AUC of the combined assessment of the four indicators for poor prognosis was 0.954. Conclusion The preoperative GCS score, hematoma volume, modified CT score, and APTT have a certain value in evaluating the poor prognosis of traumatic intracranial hematoma, and the combined evaluation effect is better