| ObjectiveIn patients with traumatic craniocerebral injury（TBI）,the related factors were excluded,and the related factors of syndrome of inappropriate anti diuretic hormone（SIADH）and cerebral salt wasting syndrome（CSWS）were analyzed more accurately and comprehensively.At the same time,to explore the differences of related risk factors and their different diagnosis and treatment strategies of syndrome of inappropriate antidiuretic hormone and cerebral salt wasting syndrome after traumatic craniocerebral injury,so as to prepare for the early occurrence of hyponatremia in traumatic craniocerebral injury.and timely determine the type of hyponatremia,in order to take corresponding clinical measures to better improve the prognosis of such patients.MethodsA retrospective analysis of 1015 patients with traumatic brain injury admitted to the neurosurgery department of two Grade A hospitals in Lianyungang city from January 1,2015 to January 1,2021 was conducted,including 334 cases of hyponatremia（23 cases of insufficient sodium intake,16 cases of overuse of diuretics,135 cases of SIADH,160 cases of CSWS）.In 334 cases of patients with general condition,injury mechanism,damage type and location and whether the operation line of single factor analysis and multiple factors such as Logistic back.ResultsUnivariate analysis was performed for patients with SIADH in TBI patients,and there was statistical significance in deceleration injury,frontal injury,tempor al injury,brain contusion,acute external dural diffuse axonal injury and skull bas e fracture（P<0.05）,Logistic regression showed:Temporal injury（P=0.037,OR=1.711,95%CI=1.032～2.838）,Diffuse axonal injury（P=0.012,OR=2.458,95%CI=1.214～4.979）,Cerebralcontusion（P=0.002,OR=2.751,95%CI=1.458～5.192）,Acute epidural hemorr hage（P=0.008,OR=2.153,95%CI=1.218～3.804）,Skull base fracture（P=0.029,OR=2.627,95%CI=1.102～6.262）was an independent risk factor for SIADH in TBI patie nts.Univariate analysis was performed for patients with CSWS in TBI patients,G CS≤8,Temporal injury,occipital injury,traumatic subarachnoid hemorrhage,acute s ubdural hemorrhage Diffuse axonal injury skull base fracture and surgery were sta tistically significant（P<0.05）,Logistic regression results showed that:GCS≤8（P=0.017,OR=1.731,95%CI=1.104～2.714）,temporal injury（P=0.027,OR=1.803,95%CI=1.069～3.042）,Diffuse axonal injury（P=0.008,OR=2.430,95%CI=1.264～4.670）,Traumat ic subarachnoid hemorrhage（P=0.005,OR=2.637,95%CI=1.342～5.181）,Acute subdu ral hemorrhage（P=0.037,OR=1.864,95%CI=1.038～3.350）,the fracture of the skull base（P=0.006,OR=3.078,95%CI=1.379～6.872）,Surgery（P=0.000,OR=3.326,95%CI=2.112～5.239）was an independent risk factor for CSWS in TBI patients.ConclusionIn this paper,through a retrospective study of the same sample,the relevant risk factors affecting SIADH and CSWS in TBI patients were obtained more ac curately and comprehensively under the condition of excluding relevant interferen ce factors Univariate analysis confirmed that deceleration injury,frontal injury,te mporal injury,brain contusion,acute epidural hemorrhage,diffuse axonal injury a nd skull base fracture were risk factors for SIADH;GCS ≤8,temporal injury,occi pital injury,traumatic subarachnoid hemorrhage,acute subdural hemorrhage,diffuse a xonal injury,skull base fracture and surgery are risk factors for CSWS.Multivariat e analysis showed that temporal injury,diffuse axonal injury and skull base fract ure were the common independent risk factors for SIADH and CSWS,while bra in contusion and acute epidural hemorrhage were the independent risk factors for SIADH.GCS ≤8,traumatic subarachnoid hemorrhage,acute subdural hemorrhage and surgery are independent risk factors for CSWS,and there are significant diff erences between them in the above related factors.Through this study,the types of hyponatremia that are easy to be diagnosed early for these risk factors in clin ical practice and timely intervention can improve the prognosis of TBI patients. |
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