本文關(guān)鍵詞：彌漫性軸索損傷遠(yuǎn)期預(yù)后影響因素分析　出處：《中國(guó)臨床神經(jīng)外科雜志》2016年11期 　論文類型：期刊論文

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【摘要】：目的探討彌漫性軸索損傷(DAI)遠(yuǎn)期預(yù)后的影響因素。方法回顧性分析2010年1月至2015年5月收治的236例DAI的臨床資料,傷后6個(gè)月,采用GOS評(píng)估遠(yuǎn)期預(yù)后。采用多因素Logistic回歸分析檢驗(yàn)影響因素。結(jié)果 236例中,死亡29例(12.3%),植物生存或僅有最小意識(shí)反應(yīng)18例(7.6%),重殘42例(17.8%),中殘38例(16.1%),恢復(fù)良好109例(46.2%)。預(yù)后良好(GOS評(píng)分4~5分)147例(62.3%),預(yù)后不良(GOS評(píng)分1~3分)89例(37.7%)。多因素Logistic回歸分析結(jié)果顯示,年齡、運(yùn)動(dòng)評(píng)分、瞳孔反應(yīng)和Levi-CT分級(jí)是評(píng)估DAI患者遠(yuǎn)期預(yù)后的獨(dú)立良好指標(biāo)。結(jié)論年齡60歲、運(yùn)動(dòng)評(píng)分1~2分、瞳孔異常和Levi-CT分級(jí)Ⅱ~Ⅲ級(jí)是DAI患者遠(yuǎn)期預(yù)后不良的獨(dú)立危險(xiǎn)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.
【作者單位】： 中國(guó)人民解放軍武漢總醫(yī)院神經(jīng)外科;浙江大學(xué)醫(yī)學(xué)院附屬第一醫(yī)院神經(jīng)內(nèi)科;浙江大學(xué)醫(yī)學(xué)院;南方醫(yī)科大學(xué);
【基金】：全軍醫(yī)學(xué)科技“十二五”重點(diǎn)項(xiàng)目(BWS11J066)
【分類號(hào)】：R651.15
【正文快照】： 彌漫性軸索損傷(diffuse axonal injury,DAI)指頭部受外力作用后,主要彌漫分布于腦白質(zhì),以軸索為主要改變的原發(fā)性腦實(shí)質(zhì)的損傷,為顱腦損傷的特殊類型,早期主要造成意識(shí)障礙;傷晚期,輕則遺留情感、注意、記憶和執(zhí)行等認(rèn)知功能障礙,重則會(huì)長(zhǎng)期處于最小意識(shí)狀態(tài)、植物生存狀態(tài),，

本文編號(hào)：1342282