颅脑损伤开颅术后并发颅内血肿危险因素分析  

Analysis of risk factors related to intracranial hematoma after craniotomy in patients with traumatic brain injury

作　　者：梁伟 张学军 王东挺 祝韬 LIANG Wei;ZHANG Xue-jun;WANG Dong-ting;ZHU Tao(Department of Neurosurgery, Huizhou City Central Hospital, Huizhou 516006, China)

机构地区：[1]中信惠州医院神经外科,广东惠州516006

出　　处：《中国临床神经外科杂志》2017年第12期819-820,823,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨颅脑损伤开颅术后发生颅内血肿的危险因素。方法回顾性分析165例颅脑损伤病人的临床资料,采用多因素Logistic回归分析检验开颅术后发生颅内血肿的危险因素。结果 165例中,术后发生颅内血肿30例,未发生135例。多因素Logistic回归分析发现,舒张压增高(OR=1.279;95%CI:1.247~1.312;P<0.001)、凝血酶时间异常(OR=4.151;95%CI:2.500~6.891;P<0.001)、颅骨骨折(OR=1.076;95%CI:1.021~1.135;P=0.008)、去骨板减压术(OR=1.162;95%CI:1.013~1.334;P=0.035)是颅脑损伤开颅术后发生颅内血肿的独立危险因素。结论对于存在血压异常、凝血功能异常、颅骨骨折以及行去骨板减压术的颅脑损伤,开颅术后应注意防止继发性颅内血肿。Objective To analyze the risk factors related to intracranial hematomas after craniotomy in the patients with traumatic brain injury(TBI).Methods Of165patients with TBI,30(observed group)had intracranial hematomas after craniotomy and135(control group)not.The factors related to intracranial hematomas were analyzed by monofactorial and multivariate logistic regression analyses.Results The monofactorial analysis showed that the factors related to intracranial hematomas after craniotomy included the skull fracture,epidural hematoma,subdural hematoma,decompressive craniectomy,and abnormal diastolic pressure,thrombin time(TT),activated partial thomboplastin time and number of blood platelet in the patients with TBI(P<0.05).Multiple Logistic regression analysis showed that high blood pressure(OR=1.279),short TT(OR=4.151),skull fracture(OR=1.076),decompressive craniectomy(OR=1.162)were risk factors in the patients with TBI.Conclusion It is suggested that the risk factors related to the intracranial hematomas after craniotomy include high blood pressure,short TT,skull fracture and decompressive craniectomy in the patients with TBI.

关 键 词：颅脑损伤 开颅手术 颅内血肿 危险因素 

分 类 号：R651.15[医药卫生—外科学] R651.11[医药卫生—临床医学]