| Objective: To explore the mechanism and potential risk factors of post-traumatic brain injury sever(TBI)after traumatic brain injury(TBI),and to improve the understanding of traumatic cerebral infarction.At the same time,it should guide the clinical evaluation of high-risk patients in a correct and timely manner,prevent and actively treat traumatic cerebral infarction as early as possible,reduce the adverse effects of traumatic cerebral infarction on patients,and improve the quality of life of patients in the later period.Methods:Through the first affiliated hospital of Guang Xi medical university electronic medical record system and medical imaging system collects the solstice 2014-1-1 to our hospital during the 2018-12-31 day for craniocerebral trauma neurosurgery of hospitalized patients with one or two units related information,pick out 93 up to the standard of severe craniocerebral injury patients,and analyze the related of their data by retrospective study.Patients were divided into PTCI-free group and PTCI-free group according to CT or MRI findings.Gender,age and Glasgow Coma Scale were recorded.GCS),epidural hematoma,subdural hematoma,intracranial hematoma,brain contusion,subarachnoid hemorrhage,skull fracture,hospital skull CT examination in presence of cerebral hernia,whether surgery after admission and whether joint bone flap,the highest temperature in 24 hours after admission,the hospital blood pressure measurement,pulse pressure difference,the first time after admission blood sodium,blood magnesium value,blood sugar,blood coagulation function,platelet value,erythrocyte hematocrit,intake,dehydration medicine last time,hemostatic time may be related to factors such as the continuous use is analyzed,and discuss the difference is significant.IBM SPSS Statistics 22.0 statistical software was used for statistical analysis.The univariate analysis was performed by chi-square test,the measurement data were measured as (?)±S,and the independent sample T-test was used,with P<0.05 as a significant difference.Binary Logistic multivariate regression analysis was performed on the statistically significant univariates to compare whether they were statistically significant.Results: Among the 93 patients with severe craniocerebral injury studied,13 patients successively developed cerebral infarction of different degrees,with a rate of 13.98%.The Glasgow outcome score at discharge showed good outcomes in 26 patients(28.0%),moderate disability in 21(22.6%),severe disability in 19(20.4%),plant survival in 12(12.9%),and death in 15(16.1%),with an excellent ratio of 50.6%.After single factor test analysis,there were significant differences in subarachnoid hemorrhage,cerebral hernia,intraoperative combined bone flap removal,and RBC specific volume between the cerebral infarction group and the non-infarction group(P<0.05).Multivariate binary Logistic regression analysis showed that subarachnoid hemorrhage and cerebral hernia were important risk factors for secondary traumatic cerebral infarction after severe head injury(OR>1,P<0.05).Conclusion: Severe craniocerebral injury has relatively high morbidity and mortality,which seriously endangers the survival and prognosis of patients.After statistics the single factor analysis of multiple factors of severe craniocerebral injury patients with subarachnoid hemorrhage of traumatic cerebral infarction and cerebral hernia is secondary to the two important risk factors,in the process of clinical treatment of severe craniocerebral injury patients,we can according to the risk factors of patients with early evaluation and identification of high-risk patients,related risk factors in a timely manner,to reduce the occurrence of traumatic cerebral infarction has important clinical significance. |
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