重型颅脑损伤患者术中低血压及术后死亡的危险因素

发布时间：2018-05-03 03:09

本文选题：重型颅脑损伤 + 危险因素　；参考：《广东医学》2015年24期

【摘要】：目的探讨重型颅脑损伤患者术中低血压及术后死亡的危险因素。方法收集重型颅脑损伤患者78例,分析性别、瞳孔变化、甘露醇使用情况、过度通气情况、梯度减压情况、麻醉诱导方式、年龄、术前收缩压等因素对术中低血压的发生及术后1个月内死亡的影响。结果二元logistic回归分析显示,术前收缩压偏低是术中发生低血压的独立危险因素,术前收缩压越低,则术中低血压发生的风险越大;瞳孔变化是术后1个月内死亡的独立影响因素,而术中低血压情况不是术后1个月内死亡的独立影响因素。结论重型颅脑损伤致残率和病死率较高,严重危害患者生命,目前临床以综合救治为主,尚无特效治疗方法,因此要注重改善预后的方法和手段,虽然术中低血压并不是术后1个月内死亡的独立危险因素,但预防术中低血压的发生或缩短其持续时间,减少继发性脑损伤,仍有利于提高预后。
[Abstract]:Objective to investigate the risk factors of intraoperative hypotension and postoperative death in patients with severe craniocerebral injury. Methods Seventy-eight patients with severe craniocerebral injury were analyzed for sex, pupil change, mannitol use, hyperventilation, gradient decompression, anesthesia induction, age. The influence of preoperative systolic blood pressure and other factors on the occurrence of intraoperative hypotension and death within 1 month after operation. Results binary logistic regression analysis showed that preoperative low systolic blood pressure was an independent risk factor for hypotension during operation. The lower the preoperative systolic pressure, the greater the risk of hypotension. Pupillary change was the independent factor of death within one month after operation, but the condition of hypotension was not the independent factor of death in one month after operation. Conclusion the disability rate and fatality rate of severe craniocerebral injury are high, which seriously endangers the life of the patients. At present, the main clinical treatment is comprehensive treatment, and there is no special effect treatment, so we should pay attention to the methods and means to improve the prognosis. Although intraoperative hypotension is not an independent risk factor for death within one month after operation, preventing or shortening the duration of intraoperative hypotension and reducing secondary brain injury can still improve the prognosis.
【作者单位】：海南省人民医院神经外科;
【基金】：海南省自然科学基金资助项目(编号:20158349) 海南省卫生计生行业科研项目(编号:14A200008)
【分类号】：R651.15

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