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目的 探讨重型、特重型颅脑外伤性脑梗死的发生机制及危险因素,为降低外伤性脑梗死的发生率和病死率提供依据.方法 对62例外伤性脑梗死患者(研究组)与680例未发生脑梗死的重型、特重型颅脑外伤患者的性别、年龄、伤情(GCS评分)、颅底骨折、脑疝、感染、手术、低血压、脱水药、活血药等因素进行调查和对照分析.结果 伤情、脑疝与否、感染与否、低血压、脱水药及活血药的使用与否等因素与外伤性脑梗死的发生密切相关(P＜0.05).结论 伤情、脑疝与否、感染与否、低血压、脱水药的过量使用等是外伤性脑梗死的常见危险因素,活血药的使用是外伤性脑梗死的保护因素.

Objective To explore pathogenesis and risk factors for posttraumatic cerebral infarction (PTCI) in patients with severe and extremely severe head injuries for the purpose of providing clues for reducing occurrence of PTCI and case - fatality.Methods Gender,age,Glasgow coma scale ( GCS),the presence or absence of basicranial fracture,cerebral hernia or infection,surgical modality,hypotension,and the use of diuretics and hemorheologic agents were recorded and analyzed in 62 PTCI patients ( study group) and 680 patients without PTCI (control group ) following severe and extremely severe head injuries.Results GCS,the presence or absence of cerebral hernia and/or infection,hypotension,the use of diuretics and hemorheologic agents were closely correlated with the occurrence of PTCI ( P ＜ 0.05 ).Conclusion GCS,the presence of cerebral hernia and infection,hypotension,and over - dosage of diuretics are common risk factors for PTCI,and the use of hemorheologic agents is a protective factor of PTCI in patients with severe and extremely severe head injuries.