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目的探讨老年颅脑损伤患者并发创伤性脑梗死(TCI)的危险因素。方法选取2012—2014年南方医科大学附属小榄医院神经外科收治的老年颅脑损伤患者577例,依据是否并发TCI分为对照组519例和病例组58例。比较两组患者的临床资料,TCI危险因素的分析采用多元Logistic回归分析。结果病例组患者收缩压低于对照组(P<0.05);格拉斯哥昏迷量表(GCS)评分≤8分者所占比例及脑疝、恶性脑肿胀、硬膜下血肿发生率均高于对照组(P<0.05)。多元Logistic回归分析显示,收缩压低、GCS评分低、脑疝形成、恶性脑肿胀及硬膜下血肿是老年颅脑损伤患者并发TCI的危险因素(P<0.05)。结论收缩压低、GCS评分低、脑疝形成、恶性脑肿胀和硬膜下血肿是老年颅脑损伤患者并发TCI的危险因素。
Objective To investigate the risk factors of traumatic cerebral infarction (TCI) in elderly patients with craniocerebral injury. Methods A total of 577 elderly patients with craniocerebral injury admitted to the Department of Neurosurgery, Siu Lam Hospital, Southern Medical University from 2012 to 2014 were selected and divided into control group (n = 519) and case group (n = 58) according to whether they were complicated by TCI. The clinical data of two groups were compared, and the risk factors of TCI were analyzed by multivariate Logistic regression. Results The systolic blood pressure in case group was lower than that in control group (P <0.05). The proportion of Glasgow coma scale (GCS) ≤8 and the incidence of hernia, malignant brain swelling and subdural hematoma were higher than those in control group P <0.05). Multivariate Logistic regression analysis showed that low systolic pressure, low GCS score, hernia formation, malignant brain swelling and subdural hematoma were risk factors of TCI in the elderly patients with traumatic brain injury (P <0.05). Conclusions Systolic depression, low GCS score, hernia formation, malignant brain swelling and subdural hematoma are risk factors for TCI in elderly patients with traumatic brain injury.