学龄前儿童中重型颅脑损伤预后不良相关因素分析

doi:10.3969/j.issn.1005-6483.2020.06.013

摘要/Abstract

摘要： 目的：探讨学龄前儿童中重型颅脑损伤预后不良相关因素。方法：2016年2月～2019年9月，我院收治的学龄前中重型颅脑损伤患儿143例，按照患儿出院时格拉斯哥预后评分（GOS）分为预后良好组（112例）与预后不良组（31例）。采用单因素分析影响学龄前儿童中重型颅脑损伤患儿预后不良相关因素；采用多因素Logistic回归分析影响学龄前儿童中重型颅脑损伤患儿预后独立危险因素。观察指标包括性别、年龄、体温、格拉斯哥昏迷指数评分（GCS）、血乳酸、低血压、脉搏、呼吸、凝血障碍、心肌损害、肝功能损害、感染、干预方法和干预时间窗。结果：143例患儿，预后良好112例，预后不良31例。单因素分析结果显示，两组性别、年龄、体温、血钠、血钾、低血压、脉搏、呼吸、心肌损害、肝功能损害和干预方法比较差异无统计学意义（P>0.05）；两组GCS评分、血乳酸、凝血障碍、感染和干预时间窗方法比较差异有统计学意义（P<0.05）。将上述单因素分析差异具有统计学意义的因素纳入多因素Logistic回归分析显示，GCS评分、血乳酸、凝血障碍、感染和干预时间窗为影响学龄前儿童颅脑损伤预后不良危险因素。结论：学龄前儿童中重型颅脑损伤预后不良受多因素影响，其中GCS评分、血乳酸、凝血障碍、感染和干预时间窗为其危险因素。

关键词: 学龄前儿童, 中重型颅脑损伤, 预后不良, 单因素分析, 多因素分析

Abstract: Objective：To explore the related factors of poor prognosis of moderate and severe craniocerebral injury in preschool children.Methods：The 143 cases of preschool children with moderate and severe craniocerebral injury admitted to our hospital from February 2016 to September 2019 wwere divided into good prognosis group (n=112) and poor prognosis group (n=31) according to Glasgow prognosis score (GOS) at discharge.Univariate analysis was used to analyze the related factors affecting the prognosis of children with moderate and severe craniocerebral injury，and multivariate logistic regression was used to analyze the risk factors affecting the prognosis of children with moderate and severe craniocerebral injury.Survey data included gender，age，body temperature，Glasgow coma index score (GCS)，blood lactate，hypotension，pulse，breathing，coagulation disorder，myocardial damage，liver function damage，infection，intervention method and time window.Results：Among 143 children with moderate or severe craniocerebral injury，112 had good prognosis and 31 had poor prognosis.Univariate analysis showed that there were no significant differences in gender，age，body temperature，hypotension，pulse，respiration，myocardial damage，liver function damage and intervention method between the two groups (P>0.05); there were significant differences in GCS score，blood lactic acid，coagulation disorder and infection between the two groups (P<0.05).The results of logistic regression analysis showed that GCS score，blood lactic acid，coagulation disorder，infection and time window were the risk factors for the prognosis of craniocerebral injury in preschool children.Conclusion：The poor prognosis of moderate and severe craniocerebral injury in preschool children is influenced by many factors，among which GCS score，blood lactic acid，coagulation disorder，infection and time window are the risk factors.

Key words: preschool children, moderate and severe craniocerebral injury, poor prognosis, single factor analysis, multifactor analysis

李政委, 王杭州, 朱炳鑫等. 学龄前儿童中重型颅脑损伤预后不良相关因素分析[J]. 临床外科杂志, 2020, 28(6): 545-547.

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