急性颅脑损伤预后因素的探讨

目的探讨影响急性颅脑损伤预后的相关因素。方法总结2006年1月至2009年10月间入院治疗的142例重型闭合性颅脑损伤患者病情演化情况,从GCS评分、年龄、颅脑损伤类型、手术时机、高血糖、呼吸功能不全和继发大面积脑梗死等方面综合分析多种因素与预后的关系。结果 GCS评分越低,病死率越高;随着年龄的增长,生存概率也随之下降;合并弥漫性脑肿胀、广泛性脑挫裂伤、脑内多发性血肿、脑干损伤患者较以单发性颅内血肿为主要表现者病死率高;伴有明显血糖值升高、呼吸功能不全、并发大面积脑梗死者与颅脑损伤的程度有关,并对疾病预后产生不利影响。结论脑损伤的程度类型及年龄因素直接影响预后,但手术时机、损伤后高血糖、呼吸功能不全、并发大面积脑梗死等因素对重型闭合性颅脑损伤的预后也产生重要的影响。

A preliminary study on the prognostic factors in acute craniocerebral trauma

Objective To determine the influential factors relevant to the prognosis of acute craniocerebral trauma.Methods A retrospective study was conducted in 142 patients who suffered acute craniocerebral injury and were hospitalized in our department from Jan.2006 to Oct.2009.The influential factors were analyzed,which included pathogenetic condition,Glasgow Coma Scale,age, type of injury,timing of operation,blood glucose level,respiratory function and secondary cerebral infarction.Results The lower Glasgow Coma Scale and the elder age led to a higher fatality. Diffused cerebral edema,extensive contusion and laceration,multiple hematomas,and brainstem injury decreased the survival rate significantly,compared with the single intracranial hematoma.High blood glucose level,dysfunction of respiration,and large cerebral infarction were associated with the severity and prognosis of the disease.Conclusions The type of trauma and the age of the patient affect the prognosis directly.The timing of operation,high blood glucose,large cerebral infarction, and dysfunction of respiration also have an influence on the outcome.