外伤后急性弥漫性脑肿胀术中急性脑膨出相关危险因素分析  

Risk factors for acute encephalocele during operation in patients with post-traumatic acute diffuse brain swelling

作　　者：孙瑾[1] 张俊卿[1] 黄延林[1] 田新华[1] 

机构地区：[1]厦门大学附属中山医院神经外科,厦门361002

出　　处：《中华神经创伤外科电子杂志》2016年第4期215-219,共5页Chinese Journal Of Neurotraumatic Surgery：Electronic Edition

基　　金：2014年厦门市科技局基金项目(3502Z20144016);2015年福建省青年基金项目(2015-2-50)

摘　　要：目的探讨外伤后急性弥漫性脑肿胀PADBS术中急性脑膨出相关危险因素。方法对厦门大学附属中山医院神经外科自2010年1月至2015年12月收治的58例PADBS开颅减压术中发生急性脑膨出(病例组)与47例同期术中未发生脑膨出(对照组)患者的性别,年龄,受伤至手术时间,减速性颅脑损伤,合并多发伤,颅脑CT血肿厚度,脑疝,术前GCS评分,术中低血压,手术方式进行病例对照研究,通过Logistic多因素回归分析术中急性脑膨出相关危险因素。结果 Logistic多因素回归分析显示减速性颅脑损伤,术前GCS评分,脑疝,术中低血压与PADBS术中急性脑膨出发生密切相关。结论减速性颅脑损伤,术前GCS评分,脑疝,术中低血压是PADBS发生术中急性脑膨出的独立危险因素,术前准确评估伤情及术中积极控制可降低PADBS术中急性脑膨出发生风险。Objective To explore the risk factors of acute encephalocele during operation in patients with PADBS（post-traumatic acute diffuse brain swelling）. Methods Gender, age, time from injured to operation,deceleration craniocerebral injury, multiple injuries,cranial CT scan hematoma thickness,hernia, GCS scale before operation, hypotension during operation, operation methods were recorded and analyzed the risk factors in 58 acute encephalocele during operation in patients with PADBS（study group）and 47 patients without acute encephalocele（control group）by multi-factor regression analysis. Results Deceleration craniocerebral injury, hernia, GCS scale before operation,hypotension during operation were closely correlated with the occurrence of acute encephalocele during operation. Conclusions Deceleration craniocerebral injury, hernia, GCS scale before operation,hypotension during operation are the risk factors for acute encephalocele during operation. Precise evaluation before operation and active control during operation will reduce the risk of acute encephalocele during operation in patients with PADBS.

关 键 词：弥漫性脑肿胀 脑膨出 危险因素 发病机制 

分 类 号：R651.15[医药卫生—外科学]