【摘要】 目的 探讨格拉斯哥昏迷评分(GCS)及CT评分在中重型颅脑损伤患者预后预测中的价值。方法 收集2019年6月—2021年6月山西省人民医院神经外科收治的248例中重型颅脑损伤患者的临床资料，随访患者住院存活情况、伤后6月的预后情况。运用SPSS 26.0软件对资料进行单因素、多因素分析，筛选预后相关的独立危险因素，采用Logistic回归分析影响中重型颅脑损伤患者住院死亡率及远期预后的危险因素，并建立预测模型，评估其预测预后的效能。结果 多因素分析显示GCS评分和Rotterdam CT评分是影响中重型颅脑损伤患者住院死亡率的独立危险因素(P<0.05),年龄、GCS-P评分和Helsinki CT评分是预测中重型颅脑损伤患者远期预后的独立危险因素(P<0.05),基于这些危险因素建立预测模型，其预测住院死亡率和远期预后的效能较单一指标明显提高。结论 GCS运动评分和Rotterdam CT评分是影响中重型颅脑损伤患者住院死亡率的独立危险因素；年龄、GCS-P评分和Helsinki CT评分是影响中重型颅脑损伤患者远期预后的独立危险因素。GCS运动评分和Rotterdam CT评分预测中重型颅脑损伤住院死亡率最强；年龄+GCS-P评分+Helsinki CT评分预测远期预后总体效能最强。更多还原

【Abstract】 Objective To explore the related factors that influence the in-hospital mortality and long-term prognosis of patients with moderate and severe traumatic brain injury, and evaluate the value of GCS score and CT score in predicting the prognosis of moderate and severe craniocerebral injury.Methods The clinical data of 248 patients with moderate or severe traumatic brain injury admitted to Department of Neurosurgery in Shanxi Provincial People’s Hospital from June 2019 to 2021 were collected.Using SPSS 26.0 software to carry on the single factor, the multi-factor analysis, and screening prognosis related independent risk factors.Logistic regression was used to analyze the risk factors of in-hospital mortality and long-term prognosis of patients with moderate and severe traumatic brain injury.Results Multivariate analysis showed that GCS motor score and Rotterdam CT score(P<0.05) were the independent risk factors for in-hospital mortality of patients with moderate or severe traumatic brain injury, and age, GCS-P score and Helsinki CT score(P<0.05) were independent risk factors for predicting the long-term prognosis of patients with moderate or severe traumatic brain injury.Its efficacy in predicting in-hospital mortality and long-term prognosis was significantly higher than that of single index.Conclusion GCS motor score and Rotterdam CT score are independent risk factors for in-hospital mortality of patients with moderate or severe traumatic brain injury.Age, GCS-P score and Helsinki CT score are independent risk factors for long-term prognosis in patients with moderate or severe traumatic brain injury. The model of GCS motor score+Rotterdam CT score is the strongest predictor of in-hospital mortality, and the model of age+GCS-P score+Helsinki CT score is the strongest predictor of long-term prognosis.更多还原