[摘要] 目的 分析重型颅脑损伤患者行去骨瓣减压术术后HCT(红细胞压积)值和短期预后之间的相关性。方法 方便选取该院2016年2月—2019年1月收治的89例重型颅脑损伤患者为研究对象，对其临床资料行回顾性分析，所有患者均行去骨瓣减压术，对其性别、年龄以及手术前后相关检验结果进行记录，分析HCT和短期预后之间的相关性。结果 单因素与多因素Logistic回归分析显示，影响重型颅脑损伤患者行去骨瓣减压术术后短期预后的因素包括术后HCT值(OR=1.031)、ISS评分(OR=1.157)、入院GCS评分(OR=0.720)以及年龄(OR=1.031);多元线性回归分析结果显示，影响术后HCT值的独立危险因素包括术中胶体输入量(β=-0.005)、术前HCT值(β=0.409)、入院 GCS评分(β=0.298)。结论 术后HCT是去骨瓣减压术后对重型颅脑损伤患者短期预后产生影响的重要危险因素，术中输注胶体液少、术前HCT高、入院的GCS评分高的重型颅脑损伤患者术后HCT值降低更小。

 [关键词] 重型颅脑损伤;去骨瓣减压术;HCT值;短期预后;相关性

 [中图分类号] R651 [文献标识码] A [文章编号] 1674-0742(2019)10(c)-0095-03

 [Abstract] Objective To analyze the correlation between HCT (hematocrit) value and short-term prognosis after decompressive craniectomy in patients with severe head injury. Methods Eighty-nine patients with severe craniocerebral injury admitted to the hospital from February 2016 to January 2019 were conveniently selected into the study. The clinical data were retrospectively analyzed. All patients underwent decompressive craniectomy. The age and related test results before and after surgery were recorded to analyze the correlation between HCT and short-term prognosis. Results Univariate and multivariate logistic regression analysis showed that the short-term prognosis of patients with severe craniocerebral injury after decompressive craniectomy included postoperative HCT (OR=1.031)， ISS score (OR=1.157)， admission GCS score (OR=0.720) and age (OR=1.031); multiple linear regression analysis showed that independent risk factors affecting postoperative HCT values included intraoperative colloidal input (β=-0.005)， preoperative HCT value (β=0.409)， admission GCS score (β=0.298). Conclusion Postoperative HCT is an important risk factor for the short-term prognosis of patients with severe craniocerebral injury after decompressive craniectomy. Intraoperative infusion of colloidal fluid， high preoperative HCT， and high GCS score of hospitalized patients with severe craniocerebral injury of the patient's postoperative HCT value decreased less.

 [Key words] Severe craniocerebral injury; Decompressive craniectomy; HCT value; Short-term prognosis; Correlation

 去骨瓣减压术是临床上用来治疗重型颅脑损伤的常见手术方式，能促使患者颅内压迅速降低，将脑灌注恢复，进而对患者生命进行有效挽救[1-2]。临床有研究显示，合并损伤程度、手术时机、伤后GCS(格拉斯哥昏迷)评分以及患者年龄均是去骨瓣减压术的重要影响因素，但对术中、术后相关影响因素的研究較少[3]。HCT(红细胞压积)是指红细胞体积在血液中所占比例，急性失血患者的HCT值可对血液携氧能力进行有效反映，临床治疗颅脑损伤的主要目的在于避免患者出现继发性颅脑损伤[4-5]。该研究方便选取该院2016年2月—2019年1月收治的89例重型颅脑损伤患者，主要针对重型颅脑损伤患者行去骨瓣减压术术后HCT值和短期预后之间的相关性进行探究，现报道如下。, http://www.100md.com(刘强) 第 1 2 页 下一页
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