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目的探讨影响创伤性蛛网膜下腔出血(t SAH)患者不良预后的临床相关因素。方法回顾分析2013年11月至2015年6月收治的86例t SAH患者的临床资料。进行正规的治疗和护理,根据出院时GOS评分分为预后良好和不良组,收集两组临床资料进行对比分析。结果单因素分析显示,既往患有高血压病史、入院时昏迷(GCS<8分)、行脑外科手术、症状性脑血管痉挛(SCV)、入住ICU、达Morris-Marshall CTⅢ~Ⅳ级在预后不良组的发生率高于预后良好组(P<0.05,P<0.01);入院时GCS评分在预后不良组较预后良好组显著降低(P<0.01),红细胞分布宽度(RDW)、血清纤维蛋白原(Fib)水平较预后良好组显著增高(P<0.01,P<0.05)。多因素Logistic回归分析显示,有高血压病史、入院时昏迷、行脑外科手术、存在SCV、入住ICU、Morris-Marshall CT分级和RDW、Fib水平、GCS评分是ts AH预后的独立影响因素(P<0.05,P<0.01)。结论既往有高血压病史、入院时昏迷、行脑外科手术、并发SCV、入住ICU、高Morris-Marshall CT分级、高RDW和Fib水平及低GCS评分均是t SAH不良预后的主要危险因素。
Objective To investigate the clinical factors that influence the adverse prognosis of patients with traumatic subarachnoid hemorrhage (t SAH). Methods The clinical data of 86 patients with t SAH admitted from November 2013 to June 2015 were retrospectively analyzed. Formal treatment and nursing, according to the GOS score at discharge was divided into good prognosis and poor group, to collect two groups of clinical data for comparative analysis. Results Univariate analysis showed that patients with past history of hypertension, coma on admission (GCS <8 points), brain surgery, symptomatic cerebral vasospasm (SCV), ICU admission, and Morris-Marshall CT grade Ⅲ ~ The incidence of poor group was higher than that of the good prognosis group (P <0.05, P <0.01). On admission, the GCS score was significantly lower in the poor prognosis group than in the good prognosis group (P <0.01), and the distribution of RDW, The level of Fib was significantly higher than that in the good prognosis group (P <0.01, P <0.05). Multivariate logistic regression analysis showed that there was a history of hypertension, coma on admission, brain surgery, presence of SCV, ICU admission, Morris-Marshall CT grade, RDW, Fib level and GCS score were independent risk factors for ts AH prognosis <0.05, P <0.01). Conclusions Historically, there was a history of hypertension, coma on admission, brain surgery, SCV, ICU admission, high Morris-Marshall CT grade, high RDW and Fib levels, and low GCS scores were the major risk factors for poor prognosis of t SAH.