弹力绷带在预防去骨瓣减压患者术后硬膜下积液中的作用  

Role of Elastic Bondage in the Prevention of Subdural Effusion After Decompressive Craniectomy

作　　者：姚玉强[1] 苏亦兵[1] 乔京元[1] 阎涛[1] 史良[1] 于宁波[2] 

机构地区：[1]北京积水潭医院神经外科,北京100035 [2]南开大学计算机与控制工程学院,天津300071

出　　处：《中国微创外科杂志》2015年第7期593-596,共4页Chinese Journal of Minimally Invasive Surgery

基　　金：国家自然科学基金(项目编号:61403215)

摘　　要：目的探讨早期应用弹力绷带在去骨瓣减压术后硬膜下积液中的预防作用。方法回顾性分析2008年1月-2014年12月我科因颅脑外伤行去骨瓣减压术63例资料,2012年1月后术后早期（3天内）给予弹力绷带（弹力绷带组,n=27）,2011年12月前术后早期未应用弹力绷带（对照组,n=36）。比较2组硬膜下积液发生率及各部位硬膜下积液（同侧大脑凸面、对侧大脑凸面、同侧大脑镰旁）发生率。结果 27例（42.9%）出现硬膜下积液,早期应用弹力绷带组硬膜下积液发生率25.9%（7/27）,较对照组（20/36,55.6%）明显降低（χ^2=5.531,P=0.019）。早期应用弹力绷带组同侧大脑镰旁硬膜下积液发生率（1/27,3.7%）较对照组（12/36,33.3%）明显降低（χ^2=8.271,P=0.004）,其他部位硬膜下积液2组间比较无显著性差异。2组间硬膜下积液量的比较无显著性差异（t=-0.839,P=0.409）。结论硬膜下积液是去骨瓣减压术后常见的并发症,早期应用弹力绷带可显著降低术后硬膜下积液的发生率。Objective To evaluate whether early application of elastic bondage can reduce the incidence of subdural effusion after decompressive craniectomy. Methods We retrospectively reviewed 63 patients receiving decompressive craniectomy due to traumatic brain injury between January 2008 and December 2014. The experimental group（ n = 27） included patients who experienced early application（ within 3 days） of elastic bondage after craniectomy between January 2012 and December 2014. The control group（ n = 36） underwent decompressive craniectomy without early application of elastic bondage between January 2008 and December2011. Comparisons were performed between the two groups on the incidence of postoperative subdural effusion. Results Of the 63 patients,the total incidence of postoperative subdural effusion was 42. 9%. The occurrence of postoperative subdural effusion in the experimental group was statistically lower than that in the the control group [25. 9%（ 7 /27） vs. 55. 6%（ 20 /36）,χ^2= 5. 531,P =0. 019]. Similarly,the incidence of interhemispheric effusion in the experimental group was also significantly lower than that in the control group [3. 7%（ 1 /27） vs. 33. 3%（ 12 /36）,χ^2= 8. 271,P = 0. 004]. The incidences of post-operative subdural effusion in other locations between the two groups didn ＇t show significant differences. The volumes of subdural effusion in the two groups didn＇t reach statistic significance（ t =-0. 839,P = 0. 409）. Conclusions Subdural effusion is one of the most common complications after decompressive craniectomy. Early application of elastic bondage may reduce the incidence of post-operative subdural effusion.

关 键 词：弹力绷带 硬膜下积液 去骨瓣减压术 

分 类 号：R651.15[医药卫生—外科学]