颅脑外伤术后早期头皮切口愈合不良的危险因素分析  

Risk factors of poor healing of scalp incisions following craniotomy for cranial trauma

作　　者：管敏武[1] 王新东[1] 章建飞 胡国平[1] 严玉金[1] 余建军[1] 励勇[1] GUAN Minwu;WANG Xindong;ZHANG Jianfei(Department of Neurosurgery,the Affiliated Hospital of Ningbo University Medical School,Ningbo 315020,China)

机构地区：[1]宁波大学医学院附属医院神经外科,315020

出　　处：《浙江医学》2018年第21期2357-2359,2362,共4页Zhejiang Medical Journal

摘　　要：目的探讨颅脑外伤术后早期头皮切口愈合不良的危险因素。方法收集282例颅脑外伤开颅手术患者的临床资料,对围手术期变量进行单因素和多元logistic回归分析,筛选出颅脑外伤术后早期头皮切口愈合不良的危险因素。结果颅脑外伤术后3周有43例(15.2%)患者头皮切口愈合不良。年龄>60岁(OR=2.710,95%CI:1.423~5.232)、双侧开颅手术(OR=2.946,95%CI:1.046~8.275)、颞浅动脉损伤(OR=10.201,95%CI:2.613-41.129)、骨瓣去除(OR=13.369,95%CI:3.107~36.275)是头皮切口愈合不良的危险因素,术后肠内营养开始时间≤48h(OR=0.463,95%CI:0.372~0.964)是保护因素。结论对于高龄、双侧开颅手术、颞浅动脉损伤、骨瓣去除的患者,颅脑外伤术后早期要预防头皮切口愈合不良;术后早期开始肠内营养治疗有利于头皮切口愈合。Objective To analyze the risk factors of poor healing of scalp incisions following craniotomy for cranial trauma.Methods The clinical data of 282 patients with cranial trauma undergoing craniotomy were retrospectively reviewed.Univariate and multivariate logistic regression was used to analyze the risk factors for poor healing of scalp incisions following craniotomy.Results The poor healing of scalp incisions developed in 43 patients 3 wks following craniotomy with an incidence of 15.2%.The age>60 years(OR=2.710,95%CI:1.423-5.232),bilateral craniotomy(OR=2.946,95%CI:1.046-8.275),superficial temporal arteries injury(OR=10.201,95%CI:2.613-41.129),decompressive craniotomy(OR=11.369,95%CI:2.107-36.275)were risk factors for postoperative poor healing of scalp incisions,while enteral nutrition support beginning within 48h following craniotomy(OR=0.463,95%CI:0.372-0.964)was a protective factor(P<0.05).Conclusion For patients undergoing traumatic craniotomy with advanced age,bilateral craniotomy,superficial temporal arteries injury,decompressive craniotomy,scalp incision healing requires more attention.Early postoperative enteral nutrition support will decrease the incidence of scalp incision-related complications.

关 键 词：颅脑外伤手术 切口愈合 危险因素 

分 类 号：R651.15[医药卫生—外科学]