重型颅脑损伤患者术后脑积水的相关因素多元回归分析  

Analysis of factors related to postoperative hydrocephalus in patients with severe traumatic brain injury

作　　者：欧洋[1] 宋宝新[1] 

机构地区：[1]北京市平谷区医院神经外科,北京101200

出　　处：《国际神经病学神经外科学杂志》2015年第2期148-151,共4页Journal of International Neurology and Neurosurgery

摘　　要：目的探讨重型颅脑损伤患者术后并发脑积水相关因素。方法选取2006年3月～2013年7月在我院收治的281例重型颅脑损伤患者，将其分为脑积水组（45例）和非脑积水组（236例），采用单因素分析和Logistic多元回归法分析颅内血肿位置、手术持续时间、开放性颅脑损伤、SAH、去骨瓣减压、硬脑膜敞开、腰椎穿刺脑脊液置换等因素。结果单因素分析显示，两组患者在血肿部位、开放性颅脑损伤、SAH、去骨瓣减压、硬脑膜敞开、腰穿脑脊液置换方面差异有统计学意义（P〈0．05）；行Logistic回归分析，开放性颅脑损伤、SAH、血肿位于硬膜下或脑内、去骨瓣减压、硬脑膜敞开为并发脑积水危险因素，腰穿脑脊液置换为保护因素，差异具有统计学意义（P〈0．05）。结论开放性颅脑损伤、硬膜下或脑内血肿、SAH、术中去除骨瓣以及硬脑膜敞开是sTBI患者术后并发脑积水的危险因素；而腰穿脑脊液置换为预防术后脑积水发生的保护因素。Objective To investigate the factors related to postoperative hydrocephalus in patients with severe traumatic brain injury （sTBI）. Methods A total of 281 sTBI patients who were admitted to our hospital from March 2006 to July 2013 were divided into hy- drocephalus group （ n = 45 ） and non-hydrocephalus group （ n = 236）. Univariate and multivariate logistic regression was used to ana- lyze the factors including location of intracranial hematoma, duration of operation, open craniocerebral injury, subaraehnoid hemorrhage （SAH） , decompressive craniectomy, dura mater opening, and lumbar puncture cerebrospinal fluid （CSF） replacement. Results The univariate logistic regression analysis showed that there were significant differences in intracranial hematoma location, open craniocere- bral injury, SAH, deeompressive craniectomy, dura mater opening, and lumbar puncture CSF replacement between the two groups （P 〈 0.05 ）. The multivariate logistic regression analysis showed that there were also significant differences in above indices between the two groups （ P 〈 0.05 ）. The risk factors for postoperative hydrocephalus were open craniocerebral injury, SAH, subdural hemato- ma, intracranial hematoma, decompressive craniectomy, and dura mater opening, and the lumbar puncture CSF replacement was a pro- tective factor for postoperative hydrocephalus. Conclusions Open craniocerebral injury, subdural hematoma, intracranial hematoma, SAH, decompressive craniectomy, and dura mater opening are the risk factors for postoperative hydrocephalus, and lumbar puncture CSF replacement is the protective factor for postoperative hydrocephalus.

关 键 词：重型颅脑损伤 脑积水 多因素分析 去骨瓣减压术 腰穿脑脊液置换 

分 类 号：R651.15[医药卫生—外科学]