Evaluation on the related high-risk factors of progressive hemorrhagic injury after acute traumatic brain injury / 重庆医学

ABSTRACT

Objective To investigate the related high-risk factors of the occurrence of progressive hemorrhagic injury (PHI) after acute traumatic brain injury ,and to provide the basis for early clinical diagnosis and treatment .Methods Retrospective analysis the clinical data of 398 cases of traumatic brain injury patients .According to whether PHI occurred ,the patients were divided into the progress group and non-progress group .Relevant factors with progressive hemorrhagic injury were assessed .Results The univari-ate analysis showed that ,the age ,gender ratio ,injury to first CT time ,GCS score when admitted in hospital ,mean arterial pressure , combined with skull fracture ,combined with epidural hematoma ,combined with cerebral contusion ,bilateral injury ,subarachnoid hemorrhage ,disturbance of consciousness ,mydriasis ,volume of intracranial hematoma more than 10 mL and volume of hematoma at the first CT scanning ,Platelets ,plasma fibrin concentration and D-dimer influenced the development of progressive hemorrhagic in-jury(P<0 .05) .Logistic regression showed that ,injury to first CT time ,GSC score less than 12 ,disturbance of consciousness ,my-driasis ,volume of hematoma more than 10 mL at the first CT scanning ,combined with cerebral contusion ,combined with subarach-noid hemorrhage ,platelet and D-dimer were the independent risk factors for PHI (P<0 .05) .Conclusion Patients with acute brain injury should be promptly head CT .Patients with GCS score less than 12 ,disturbance of consciousness ,mydriasis ,volume of in-tracranial hematoma more than 10 mL at the first CT scanning ,combined with cerebral contusion ,subarachnoid hemorrhage ,platelet and D-dimer were the independent risk factors of the progressive hemorrhagic injury after traumatic brain injury ,Should closely ob-serve the illness progress ,regularly review the head CT as soon as possible .