弥漫性轴索损伤远期预后影响因素分析

发布时间：2017-12-27 15:29

  本文关键词：弥漫性轴索损伤远期预后影响因素分析　出处：《中国临床神经外科杂志》2016年11期 　论文类型：期刊论文

  更多相关文章： 弥漫性轴索损伤 远期预后 影响因素 Logistic回归分析

【摘要】：目的探讨弥漫性轴索损伤(DAI)远期预后的影响因素。方法回顾性分析2010年1月至2015年5月收治的236例DAI的临床资料,伤后6个月,采用GOS评估远期预后。采用多因素Logistic回归分析检验影响因素。结果 236例中,死亡29例(12.3%),植物生存或仅有最小意识反应18例(7.6%),重残42例(17.8%),中残38例(16.1%),恢复良好109例(46.2%)。预后良好(GOS评分4~5分)147例(62.3%),预后不良(GOS评分1~3分)89例(37.7%)。多因素Logistic回归分析结果显示,年龄、运动评分、瞳孔反应和Levi-CT分级是评估DAI患者远期预后的独立良好指标。结论年龄60岁、运动评分1~2分、瞳孔异常和Levi-CT分级Ⅱ~Ⅲ级是DAI患者远期预后不良的独立危险因素。
[Abstract]:Objective to investigate the factors affecting the long-term prognosis of diffuse axonal injury (DAI). Methods the clinical data of 236 cases of DAI from January 2010 to May 2015 were analyzed retrospectively. 6 months after injury, the long-term prognosis was evaluated by GOS. Multiple factor Logistic regression analysis was used to test the influencing factors. Results among the 236 cases, 29 cases died (12.3%), and 18 cases (7.6%) had plant survival or only minimal conscious reaction, 42 cases (17.8%) were severely disabled, 38 cases (16.1%) were moderately disabled, and 109 cases (46.2%) recovered well. The prognosis was good (GOS score 4~5) in 147 cases (62.3%), poor prognosis (GOS score 1~3 score) in 89 cases (37.7%). Multiple factor Logistic regression analysis showed that age, exercise score, pupil response, and Levi-CT classification were independent and good indicators for assessing the long-term prognosis of DAI patients. Conclusion 60 years of age, 1~2 score of exercise score, abnormal pupil and grade of Levi-CT grade II ~ III are independent risk factors for poor prognosis in DAI patients.
【作者单位】： 中国人民解放军武汉总医院神经外科;浙江大学医学院附属第一医院神经内科;浙江大学医学院;南方医科大学;
【基金】：全军医学科技“十二五”重点项目(BWS11J066)
【分类号】：R651.15
【正文快照】： 弥漫性轴索损伤(diffuse axonal injury,DAI)指头部受外力作用后,主要弥漫分布于脑白质,以轴索为主要改变的原发性脑实质的损伤,为颅脑损伤的特殊类型,早期主要造成意识障碍;伤晚期,轻则遗留情感、注意、记忆和执行等认知功能障碍,重则会长期处于最小意识状态、植物生存状态,，

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