成人外伤后嗅觉障碍预后不良的危险因素分析OACSTPCD
Analysis of risk factors for poor prognosis of adult post-traumatic olfactory dysfunction
目的 分析外伤后嗅觉障碍(PTOD)患者预后不良的危险因素.方法 回顾性分析2020年8月至2022年10月该院神经外科收治的625例脑外伤患者临床资料.患者分别于出院后2周、6个月进行随访,根据宾夕法尼亚大学嗅觉测试(UPSIT)评分改善情况分为预后不良组和预后良好组,分析影响预后的危险因素.结果 PTOD患者117例,发病率18.9%,其中预后良好50例,预后不良67例.单因素分析显示,预后不良组与预后良好组性别、高血压史、受伤着力部位、合并额叶挫伤、年龄、住院时间方面差异有统计学意义(P<0.05).多因素分析结果显示,年龄高(OR=1.138,95%CI:1.076~1.204,P<0.001)、住院时间长(OR=1.229,95%CI:1.064~1.420,P=0.005)、受伤时枕部着力(OR=9.123,95%CI:2.175~38.276,P=0.003)、合并额叶挫伤(OR=16.255,95%CI:3.267~80.869,P=0.001)是PTOD预后不良的独立危险因素.结论 针对受伤时枕部着力及合并额叶挫伤的PTOD患者,更要提供合理有效的治疗方案,促进嗅觉功能恢复.
Objective To analyze the risk factors for poor prognosis in the patients with post-traumatic olfactory dysfunction(PTOD).Methods A retrospective analysis was performed on the clinical data of 625 patients with brain trauma admitted and treated in the neurosurgery department of this hospital from August 2020 to October 2022.The patients were followed up in 2 weeks and 6 months after discharge respectively,and divided into the poor prognosis group and good prognosis group according to the improvement of UPSIT score.The risk factors affecting the prognosis was analyzed.Results There were 117 patients with PTOD and the incidence rate was 18.9%.The prognosis in 50 patients was good and which in 67 cases were poor.The un-ivariate analysis showed that there were statistically significant differences in the gender,history of hyperten-sion,injury site,complicating frontal lobe contusion,age and length of hospital stay between the poor progno-sis group and good prognosis group(P<0.05).The multivariate analysis results indicated that the advanced age(OR=1.138,95%CI:1.076-1.204,P<0.001),long hospitalization time(OR=1.229,95%CI:1.064-1.420,P=0.005),occipital impact(OR=9.123,95%CI:2.175-38.276,P=0.003)and complicating fron-tal lobe contusion(OR=16.255,95%CI:3.267-80.869,P=0.001)were the independent risk factors for poor prognosis in the patients with PTOD.Conclusion For PTOD patients with occipital impact and compli-cating frontal lobe contusion at the time of injury,it is even more necessary to provide reasonable and effective treatment programs to promote the recovery of olfactory function.
王成;周辉
南京医科大学连云港临床医学院/连云港市第一人民医院神经外科,江苏连云港 222000
临床医学
外伤后嗅觉障碍预后UPSIT评分额叶挫伤枕部着力
post-traumatic olfactory dysfunctionprognosisUPSIT scorefrontal lobe contusionoccip-ital impact
《重庆医学》 2024 (007)
1021-1026 / 6
连云港市第六期521高层次人才培养工程项目(LYG06521202104).
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