The Analysis Of Risk Factors Of Associated With Post-traumatic Cerebral Infarction

Background:As China's social and economic condition keeps improving,high-speed vehicles get popularized and construction industry develops rapidly,the incidence of craniocerebral injury is thus continuously rising.The craniocerebral injury causes high mortality and it makes up of 60% cases amongst various traumatic injuries.Post-traumatic cerebral infarction(PTCI)is a common complication of patients with craniocerebral injury.The clinical report that has the incidence of PTCI ranges from 1.9% to 16.67%.And the autopsy report indicates that the incidence of PTCI is 55%.PTCI often develops early after trauma,and its clinical manifestations are diverse,which is hard to detect with the presence of primary craniocerebral injury and complications of surgical complications.If PTCI is not treated promptly and effectively,the condition will be exacerbated with poor prognosis,and the mortality will reach 75%.At present,few studies have been reported on the incidence,timing and risk factors in the early stage of PTCI.Early identification of patients with high risk will help to scientifically manage patients with craniocerebral injury and prevent PTCI.Objective:To learn the clinical features and related risk factors of posttraumatic cerebral infarction in patients after traumatic brain Injury.To summarize the corresponding strategies of prevention and treatment of posttraumatic cerebral infarction.In order to reduce the incidence of posttraumatic cerebral infarction and improve the prognosis of patients with traumatic brain Injury.Method:Retrospectively analyzing of the clinical data and medical imaging data of 487 cases of eligible traumatic brain injury patients treated in Department of ICU and neurosurgery,The Second Affiliated Hospital of Zhengzhou University from June 2015 to December 2018,from which the qualified cases were divided into PTCI group(35 cases)and non PTCI(452 cases)group,according to the head CT examination results whether the occurrence of PTCI exsit or not.1.Statistics of infarction time and infarction in 35 patients in PTCI group Analysis;2,According to the gender of the two groups of patients,age,Glasgow coma scale(GCS)at admission,no cerebral hernia,hypotension shock,diabetes history,subarachnoid hemorrhage,whether to remove the bone flap Univariate and multivariate analyses were performed on PTCI risk factors including decompression and application of hemostatic drugs.SPSS 21.0 statistical software was applicated for analyzing,univariate analysis by Chi-square examination,multivariate analysis by Logistic regression.Significance level is P=0.05.3.To evaluate prognosis of patients of two groups after half year according to Glasgow outcome scale.Analysis and statistics of the prognosis of the two groups by chi-square test.Result:(1)In 487 patients after traumatic brain Injury,35 cases occurred PTCI,the incidence was 7.2%;The first week after traumatic brain injury is the high incidence of PTCI(62.9%).The PTCI infarction site is mainly located in the posterior and middle cerebral arteries(77.1%);(2)By univariate analysis,the differences of the age,Low GCS scores,cerebral hernia,hypotension shock,subarachnoid hemorrhage,the time of use hemostatic drugs(>3 days)?diabetes between the two groups was statistically significant(P<0.05),they were important risk factors of PTCI.By multivariate logistic analysis,the age,Low GCS score,cerebral hernia,hypotension shock,subarachnoid hemorrhage and diabetes were the independent risk factors for PTCI;(3)PTCI patients with severe disability and mortality were significantly higher than those in non PTCI patients,and the difference was statistically significant(P<0.05).Conclusion:(1)The first week after traumatic brain injury is the high incidence of PTCI,The PTCI infarction site is mainly located in the posterior and middle cerebral arteries;(2)The patients' age?brain herniation?subarachnoid hemorrhage?hypotension shock?diabetes and low GCS scores are the independent risk factors for PTCI;(3)Once a patient with traumatic brain injury has PTCI,it prompted poor prognosis.