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目的 :探讨儿童重型颅脑损伤近期预后的影响因素。方法 :回顾分析 5 2 2例儿童重型颅脑损伤患者的临床资料 ,依据患者出院时格拉斯哥结果分级 ( GOS)标准分为预后良和预后差两组 ,分析性别、年龄、伤因、脑损伤类型、入院时体温、脉搏、呼吸、血压、血氧饱和度、有无合并伤及格拉斯哥昏迷计分 ( GCS)等 1 1种因素对患者预后的影响。结果 :预后良组与预后差组的 GCS评分、体温、脉搏、呼吸、血压、血氧饱和度、伤因、脑损伤类型及有无合并伤之间有显著性差异 ( P<0 .0 0 1 ) ;两组性别、年龄之间无显著性差异 ( P>0 .0 5 )。仅入院时 GCS评分和有无合并伤两个因素被引入 Logistic回归方程作为影响预后的有意义因素( χ2 =5 5 .81 0 ,P<0 .0 0 1 ) ,入院时 GCS评分与出院时 GOS分级存在负相关 ( r=- 0 .766,P<0 .0 0 1 )。结论 :入院时 GCS评分和有无合并伤是判断儿童重型颅脑损伤近期预后有价值的临床指标 ,系统了解相关因素有助于合理制定治疗方案和评估预后。
Objective: To investigate the influencing factors of recent prognosis of children with severe craniocerebral injury. Methods: The clinical data of 522 children with severe craniocerebral injury were retrospectively analyzed. According to the GOS criteria at the time of discharge, the patients were divided into two groups: good prognosis and poor prognosis. Gender, age, injury, type of brain injury, Admission on the body temperature, pulse, respiration, blood pressure, oxygen saturation, with or without injury and Glasgow coma score (GCS) and other 1 1 factors on the prognosis of patients. Results: The GCS score, body temperature, pulse rate, respiration, blood pressure, oxygen saturation, injury, type of brain injury and the presence or absence of combined injury in the poor prognosis group and the poor prognosis group were significantly different (P <0. 0 0 1). There was no significant difference between the two groups in gender and age (P> 0.05). Only the admission of GCS score and the presence of combined injury were two factors introduced into the Logistic regression equation as a significant factor affecting the prognosis (χ2 = 55.881, P <0.001), admission GCS score and discharge There was a negative correlation between GOS grading (r = - 0.766, P <0.001). Conclusions: The GCS score and the presence or absence of combined injury on admission are the clinical indicators to evaluate the recent prognosis of children with severe craniocerebral injury. Understanding the related factors helps to formulate a reasonable treatment plan and evaluate the prognosis.