After Traumatic Brain Injury Clinical Study Of Delayed Intracranial Hematoma

Objective:To investigate after traumatic brain injury delayed intracranial hematomathe (delayed traumatic intracranial hematoma, DTICH) the occurrence of relevant factors,clinical features, pathogenesis and prevention measures. Strengthen the vigilance of thedisease, and the emphasis on the clinical features and the development of the law is areasonable use of dynamic CT examination for early diagnosis and aggressive treatmentof seizing the opportunity to, and effectively improve the efficacy and prognosis of thisdisease, to reduce morbidity and mortality..Methods:A retrospective analysis from January2009to December2011in Yan’anUniversity Hospital neurosurgery line acute intracranial hematoma clinical data of240patients, which found that25patients with postoperative delayed intracranial hematoma(the case group) and215cases of patients with delayed intracranial hematoma (controlgroup) did not occur. Analysis of these factors DTICH occurred in terms of gender, age,severity of head injury, brain injury type of relationship, the data observations indicatorsunivariate analysis and multivariate logistic regression analysis.Results:Univariate analysis showed significant correlation (P<0.05) in severetraumatic brain injury, cerebral contusion, epidural hematoma, skull fracture, timing ofsurgery, surgical approach, TT and APTT; Multivariate Logistic regression analysisshowed severe traumatic braininjury （OR=3.678， P=0.001） brain contusion（OR=2.374，P=0.019）,skull fracture（OR=1.760，P=0.024）andTT（OR=1.848，P=0.017）4factors for DTICH of risk factors.Conclusion: This study retrospectively analyzed the clinical data of240cases ofbrain injury after DTICH patients and head injury did not occur after the delayedtraumatic intracranial hematoma, statistical analysis shows DTICH occurrence of severe traumatic brain injury, cerebral contusion,epidural hematoma, skull fracture, timing ofsurgery, surgical approach, TT and APTT was significant (P <0.05). Gender, age,mechanism of injury, subdural hematoma, intracerebral hematoma, initial CT time, PT,hypoxemia, hypotension, and postoperative complications in the two groups was nosignificant difference (P>0.05). Univariate analysis significant independent variables inmultivariate logistic regression analysis, display the impact DTICH the risk factors ofsevere traumatic brain injury, cerebral contusion, skull fracture and TT. Therefore,patients with severe traumatic brain injury, cerebral contusion, skull fracture, and TT riskfactors after traumatic brain injury complicated by delayed intracranial hematoma. Inview of the rising trend of the incidence of brain injury, and the high mortality andmorbidity, causing huge economic losses and physical and psychological harm to society,so we should pay attention to the clinical treatment of traumatic brain injury, efforts toimprove brain trauma system monitoring system, strengthen the standardization oftreatment and basic research, and provide a better theoretical and technical support forour neurosurgeon. GCS score as more standardized, and further improved imaging andfunction tests, and improve monitoring equipment, the neural stem cell transplantation toenhance physical and rehabilitation, to improve the level of brain injury treatment toreduce head injury to society negative impact. This study is a nonrandomized,retrospective studies, and therefore there is a potential deviation and variation,postoperative delayed intracranial hematoma in patients with only25cases, the samplesize is small, for the risk factors by DTICH, clinical features and its related mechanismhas yet to be a larger sample size data, prospective study to confirm the quantitativecontrol, so as to further investigation the assessment DTICH independent risk factors.