1 徐州医科大学附属医院神经外科，江苏 徐州 221000
目的：研究老年人(年龄≥60岁)脑挫裂伤经手术治疗后影响预后的相关因素，为早期临床干预提供指导，提高患者生活质量。方法：系统性收集徐州医科大学附属医院2015年1月至2018年12月收治的脑挫裂伤患者，所有患者于入院3 d内完成手术治疗。回顾性分析性别、年龄、术前瞳孔变化、凝血功能、术前格拉斯哥(Glasgow Coma Scale，GCS)评分、首次Rotterdam CT评分、有无高血压、糖尿病等临床资料，以术后至少6个月格拉斯哥预后(Glasgow Outcome Scale，GOSE)评分为预后评价指标(1~4分预后较差，5~8分预后良好)进行统计学分析，得出与患者预后相关的因素。结果：93例患者中，33例取得良好的预后，预后良好率为35.48%。单因素分析发现：年龄、术前GCS评分、首次Rotterdam CT评分、凝血功能、瞳孔变化与患者预后有关，性别、有无高血压、糖尿病与患者预后无明显相关。多因素分析发现：凝血功能、首次Rotterdam CT评分是影响患者预后的独立危险因素。结论：凝血功能和首次Rotterdam CT评分是影响患者的预后独立危险因素，首次Rotterdam CT评分不仅可以判断患者病情的危重程度，而且可以初步判断患者预后恢复情况。关键词： 老年人；脑挫裂伤；手术治疗；预后因素
Prognostic factors of cerebral contusion and laceration in the elderly after surgical treatment
CorrespondingAuthor:FENG Li Email: email@example.com
Foundation: This work was supported by the Jiangsu Natural Science Foundation, China (BK20181152).
Objective: To study the prognostic factors of cerebral contusion and laceration in the elderly (age ≥60 years) after surgical treatment, to provide guidance for early clinical intervention and improve patients’ quality of life. Methods: Patients with cerebral contusion and laceration of Xuzhou Medical College Affiliated Hospital between January 2015 and December 2018 were systematically collected. All patients are completed surgical treatment within 3 days of hospitalization. Analyze the clinical data (including gender, age, preoperative pupil change, coagulation function, preoperative Glasgow Coma Scale (GCS) score, first Rotterdam CT, with or without hypertension, diabetes). The Glasgow Outcome Scale (GOSE) score (1–4 poor prognosis, 5–8 good prognosis) at least 6 months after surgery was used as the prognostic index for statistical analysis to obtain factors related to patients prognosis. Results: Among the 93 patients, 33 had a good prognosis, with a good prognosis rate of 35.48%. Univariate analysis showed that age, preoperative GCS score, first Rotterdam CT score, coagulation function and pupil changes were related to the prognosis of the patients, while gender, presence or absence of hypertension and diabetes were not significantly related to the prognosis of the patients. Multivariate analysis showed that coagulation function and first Rotterdam CT were independent risk factors affecting the prognosis of patients. Conclusion: Coagulation function and first Rotterdam CT score are independent risk factors of affecting the prognosis of patients. The first Rotterdam CT score can not only determine the severity of the patient’s condition but also preliminarily determine the prognosis and recovery of the patient.Keywords： old people; cerebral contusion and laceration; surgical treatment; prognostic factors