| Background&Objective:Brain injury is a common disease, according to statistics from different periods of the world, the incidence of craniocerebral injury after limbs fracture, but the fatality rate in the first place.With the continuous improvement of social economy, the popularity of high-speed transportation, rapid development of construction industry, a variety of fast, stimulating sports so that the incidence of brain injury emerge in an endless stream, also continued to show increasing trend.1965 in Beijing craniocerebral injury special meeting revised the acute closed craniocerebral injury type, according to the time of coma, positive signs and life signs are divided into light,, triple type and in 1978 in Nanjing the second session of the Chinese psychiatric neuroscience conference, by severe craniocerebral injury and separation of the particularly severe.The above classification has become a nationally recognized standards, which severe craniocerebral injury:deep coma, time in more than 12 hours, disturbance of consciousness gradually increased or re coma. Obvious positive signs of nervous system, body temperature, respiration, pulse and blood pressure changes.Severe craniocerebral injury:primary brain injuries, after deep coma, to organ injury to the brain tonic or accompanied by other parts, shock. Have advanced cerebral hernia, including bilateral mydriasis and vital signs of a serious disorder or breathing has nearly stopped.Due to the severity of brain injury and coma time and degree should be relatively positively correlated, so Teasdale and Jennett put forward the Glasgow coma score (GCS score).Severe craniocerebral injury refers to GCS score in 6 to 8 minutes, after injury coma in 6 hours or more, or of deterioration of consciousness within 24 hours after injury, again in a coma for more than six hours’. Severe type craniocerebral injury refers to a GCS score 3-5 minutes, after injury coma.Our country in recent years, with the rapid growth of vehicle ownership, the number of traffic accidents increased significantly, craniocerebral injury death toll has increased year by year.Domestic Beijing, Shanghai and other 6 city craniocerebral injury incidence rate of 783.3/10 million people, the annual mortality rate was 6.3/10 million.Brown of 7175 cases of craniocerebral injury patients in 1985-2000 were retrospectively studied, found in severe craniocerebral injury within 30 days, the mortality rate is about 29.3%.In the past 20 years, although in the prevention and treatment of craniocerebral injury has made a great progress, the mortality was significantly decreased, but craniocerebral injury incidence of threw a high, rehabilitation difficult for many wounded legacy disabled, so that the wounded into society, in the developed countries and the developing countries is still a major health and social problems.Craniocerebral injury incidence rate showed 3 peaks, respectively in children, young adults, aged 75 years. Especially in childhood and young adults with severe traumatic brain injury to the family and society the greatest impact.Especially in childhood and young adults with severe traumatic brain injury to the family and society the greatest impact.A family in treatment of traumatic brain injury patients need to bear the economic loss, some families even lose the economic source and returning, to the society bring unstable factors; on the other hand, young labor force of disability, death to the society bring huge losses.Therefore, this paper analyzes and summarizes the factors affecting prognosis of patients with severe craniocerebral injury, and help to further improve the level of treatment of traumatic brain injury.Human survival state need to breathe, circulation, nerve function of the system is normal. For patients with severe craniocerebral injury and the integrity of the nervous system function is prerequisite for the survival of patients. The nervous system and in the brainstem, diencephalon most important, diencephalon and brainstem structures and functional integrity is maintained endocrine, respiratory system, circulatory system and other system normal function of the premise. In patients with severe traumatic brain injury often associated with varying degrees of brain injury, including the telencephalon, diencephalon and brainstem injury. These damage can lead to secondary brain edema, final compression of the brain stem, so that patients with brainstem function failure and death.On patients with severe traumatic brain injury prognosis assessment of prognosis in patients with early stage is the selection of treatment scheme, the allocation of resources, classification of the patients, and to communicate with patients and their families a important factor; especially the GCS 6-8 patients, survival and the chance of survival is high, is a problem of common concern in the neurosurgeon and family members of patients.For domestic and foreign experts neurological factors affecting prognosis in patients with severe craniocerebral injury were the effects of many animal experiments and clinical studies.For now, clinical factors mainly reflected in whether age Ⅱ sex admission mGCS score 4 modified CT image scores. Hernia the volume of intracranial hematoma, cerebral contusion and laceration of the scope of the intracranial hematoma location. However, such studies mostly by single factor analysis based, lack of single factor and the interaction between the single factor study.This research aims at the effect of severe craniocerebral injury and the prognosis of patients with possible factors correlation analysis, not only the clinical easy tramping the factors taken into account, also will be the interaction between the factors and effects are taken into account.Internet severe craniocerebral injury with high mortality, and present medical condition, there is no effective method to improve the prognosis of the patients, so severe craniocerebral injury is not within the scope of this study, the research for GCS score in the 6-8 hours of severe craniocerebral injury patients. In data processing, according to statistics, based on the possible factors to influence the prognosis of the patients were analyzed by univariate analysis, to have statistically significant factors into the application of Cox proportional hazard regression model, multivariate analysis was carried out that effect of severe craniocerebral injury and the prognosis of patients with clinical factors. By multiple factor analysis obtained result is more scientific and reliability.Subjects and Methods1.1 The clinical data of 213 cases of severe craniocerebral injury patients admitted to Department of Neurosurgery Hospital Affiliated to Southern Medical University Huadu May 2013 -2015 year in July between the retrospective analysis.Among them,113 were male,100 female,19 people died,15 people died; mGCS2-3 83,4-5 130, the number of deaths were 21,13;>=60 years old<60 years old 157 people,56 people, the number of deaths were 20,14; admission hernia formation in 64 people, not herniation of 149 people, the number of deaths were 16,18; intracranial hematoma volume... |
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