杨元华;吴峤微;汪继虎;诸澎伟;张亦鹏;蒋蕾花;

• 1:无锡市儿童医院

摘要(Abstract)：

目的 探讨外伤导致颅脑损伤患儿的临床特点及评估预后的相关因素。方法 回顾性分析无锡儿童医院2018-05—2020-07收治的部分累及颅脑损伤的106例患儿的临床资料。其中无后遗症、并发症的78例患儿为预后良好组，死亡、后遗症、存在并发症等28例患儿为预后不良组，观察比较2组患儿性别、年龄、格拉斯哥昏迷指数评分（glasgow coma scale,GCS）、降钙素原（procalcitonin,PCT）、喂养时间、急性胃肠损伤（acute gastrointestinal injury,AGI）、肝功能损伤、甲状腺功能下降、损伤部位等临床资料。对不同颅脑损伤类型进行Logistic回归分析，分析其与预后的相关性。结果 对颅脑损伤患儿可能影响预后的因素进行对比分析，预后良好组与预后不良组GCS评分[14(12,15)分vs 8(5,9)分，P<0.01]、PCT[0.06(0.05,0.28)μg/L vs 10.91(3.55,14.12)μg/L,P<0.01]、开始喂养时间[21(12,36)h vs 51.5(36.5,87.5)h,P<0.01]、AGI分级[Ⅰ级（58例vs 9例），Ⅱ级（11例vs 10例），Ⅲ级（0例vs 9例），P<0.01]、肝功能损伤（13例vs 19例，P<0.05）、甲状腺功能下降（8例vs 16例，P<0.01）等比较，差异均有统计学意义，2组均无AGI分级Ⅳ级病例。对颅脑损害类型进行Logistic回归分析法，硬膜下血肿（β=1.741,P=0.005）、蛛网膜下腔出血（β=1.057,P=0.046）、轴索损伤（β=2.435,P=0.003）均是增加预后不良的危险因素。结论 儿童颅脑外伤与预后相关的主要因素是GCS、PCT、喂养及胃肠功能情况、肝功能、甲状腺功能及颅脑损伤类型。

关键词(KeyWords)： 颅脑外伤;降钙素原;急性胃肠损伤;儿童;颅脑损伤类型

Abstract:

Keywords:

基金项目(Foundation): 南京医科大学科技发展基金（编号：NMUB20210310）

作者(Authors): 杨元华;吴峤微;汪继虎;诸澎伟;张亦鹏;蒋蕾花;

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