重型颅脑外伤患者外科治疗后远隔位置再次手术的影响因素分析  

Analysis of Influencing Factors of Reoperation at Distant Position after Surgical Treatment in Patients with Severe Craniocerebral Trauma

作　　者：尹成[1] 刘涛[1] YIN Cheng;LIU Tao(Department of Neurosurgery,Changzhou NO.7 Hospital,Changzhou Jiangsu 213000)

机构地区：[1]常州市第七人民医院神经外科,江苏常州213000

出　　处：《医学临床研究》2021年第1期78-80,共3页Journal of Clinical Research

摘　　要：【目的】探讨重型颅脑外伤患者外科治疗后远隔位置再次手术的影响因素。【方法】回顾性分析本院收治的92例重型颅脑外伤患者的临床资料,其中20例远隔部位行再次手术(再次手术组),72例无需手术(非再次手术组)。单因素和Logistic因素分析重型颅脑外伤患者外科治疗后远隔位置再次手术的相关因素。【结果】脑千伤、脑积水、着力部位、着力部位与血肿位置、远隔部位骨折、去骨瓣减压术、手术体位、术中出血量、术中急性脑膨出均影响重型颅脑外伤患者外科治疗后远隔位置再次手术,差异有统计学意义(P<0.05)。Logistic多因素分析显示,脑干伤、脑积水、枕部着力、着力部位与血肿对侧或双侧、远隔部位骨折、去骨瓣减压术、术中急性脑膨出是重型颅脑外伤患者外科治疗后远隔位置再次手术的危险因素(P<0.05)。【结论】对于脑干伤、脑积水、枕部着力、着力部位与血肿对侧或双侧、远隔部位骨折、去骨瓣减压术、术中急性脑膨出的重型颅脑外伤患者经外科手术治疗后应加强监测,及时采取针对性措施,降低远隔位置再次手术的发生率。【Objective】To investigate the influencing factors of reoperation at distant position in patients with severe craniocerebral trauma after surgical treatment.【Methods】The clinical data of 92 patients with severe craniocerebral trauma in our hospital were retrospectively analyzed.Among them,20 patients underwent reoperation in remote part(reoperation group),72 patients did not need operation(non reoperation group).Univariate analysis and logistic analysis were used to analyze the related factors of reoperation at distant position after surgical treatment in patients with severe craniocerebral trauma.【Results】Brain stem injury,hydrocephalus,focus site,focus site and hematoma location,remote site fracture,decompressive craniectomy,operation position,intraoperative blood loss,intraoperative acute encephalocele all affected the reoperation of patients with severe craniocerebral trauma at remote location after surgical treatment,the difference was statistically significant(P<0.05).Logistic multivariate analysis showed that brainstem injury,hydrocephalus,occipital exertion,contralateral or hilateral to hematoma,distal fracture,decompressive craniectomy and intraoperative acute encephalocele were the risk factors for reoperation in patients with severe traumatic brain injury(P〈0.05).【Conclusion】For severe traumatic brain injury patients with brainstem injury,hydrocephalus,occipital exertion,contralateral or bilateral to hematoma,distal fracture,decompressive craniectomy and intraoperative acute encephalocele.monitoring should be strength ened after surgical treatment,and targeted measures should be taken in time to reduce the incidence of reoperation at distal position.

关 键 词：颅脑损伤/外科学 再手术 脑干出血 创伤性/病因学 脑积水/病因学 影响因素分析 

分 类 号：R651[医药卫生—外科学]