重型颅脑损伤伴脑疝患者标准大骨瓣开颅减压术后发生枕叶梗死的影响因素  

Influencing factors of occipital infarction after standard large craniotomy in patients with severe craniocerebral injury and cerebral hernia

作　　者：徐文中[1] XU Wen-zhong(Department of Neurosurgery,the Second Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China)

机构地区：[1]河南科技大学第二附属医院神经外科,河南洛阳471000

出　　处：《黑龙江医药科学》2021年第5期38-40,43,共4页Heilongjiang Medicine and Pharmacy

基　　金：河南省卫生和计划生育委员会科技攻关计划项目,编号:2018020924。

摘　　要：目的:分析重型颅脑损伤伴脑疝患者标准大骨瓣开颅减压术后发生枕叶梗死的影响因素。方法:回顾性分析2019-06~2020-06在河南科技大学第二附属医院接受标准大骨瓣开颅减压术后发生枕叶梗死的45例重型颅脑损伤伴脑疝患者资料,作为发生组,并收集同期医院接受标准大骨瓣开颅减压术后未发生枕叶梗死的45例重型颅脑损伤伴脑疝患者资料,作为未发生组,所有患者基线资料、实验室指标均完整,统计两组基线资料实验室指标,经单因素及多因素分析找出重型颅脑损伤伴脑疝患者标准大骨瓣开颅减压术后发生枕叶梗死的影响因素。结果:发生组与未发生组患者的格拉斯哥昏迷评分(GCS)评分、术中低血压、术前休克、大脑后动脉P2段移位比较,差异有统计学意义(P<0.05),组间其他资料比较差异无统计学意义(P>0.05);经Logistic回归分析结果显示,GCS评分高、术前休克、术中低血压、大脑后动脉P2段移位长均是重型颅脑损伤伴脑疝患者标准大骨瓣开颅减压术后发生枕叶梗死的影响因素(OR>1,P<0.05)。结论:重型颅脑损伤伴脑疝患者标准大骨瓣开颅减压术后发生枕叶梗死可能受GCS评分高、术前休克、术中低血压、大脑后动脉P2段移位长等因素的影响。Objective:To investigate the influential factors of occipital infarction after standard large craniotomy for severe craniocerebral injury with cerebral hernia.Methods:Clinical data of 90 patients with severe craniocerebral injury complicated with cerebral hernia who received standard large craniotomy decompression in the Second Affiliated Hospital of Henan University of Science and Technology from June 2019 to June 2020 were collected retrospectively.According to whether occipital infarction occurred after operation,the patients were divided into the occurrence group and the non-occurrence group,45 cases in each group.The baseline data and laboratory indicators of patients in the two groups were complete.The baseline data of the two groups were counted as laboratory indicators,and the influencing factors of occipital infarction after standard large bone flap craniotomy for patients with severe craniocerebral injury accompanied by cerebral hernia were found by univariate and multivariate analysis.Results:There were statistically significant differences in Glasgow coma score(GCS),intraoperative hypotension,preoperative shock and P2 segment displacement of posterior cerebral artery between 2 groups(P<0.05),while there were no statistically significant differences in other data between 2 groups(P>0.05).Logistic regression analysis showed that high GCS score,preoperative shock,intraoperative hypotension and long displacement of P2 segment of posterior cerebral artery were the influencing factors of occipital infarction after standard large craniotomy for patients with severe craniocerebral injury and cerebral hernia(OR>1,P<0.05).Conclusion:Occipital lobe infarction after standard large craniotomy for patients with severe brain injury and cerebral hernia may be influenced by high GCS score,preoperative shock,intraoperative hypotension and long posterior cerebral artery P2 segment displacement.

关 键 词：重型颅脑损伤 脑疝 标准大骨瓣开颅减压术 枕叶梗死 影响因素 

分 类 号：R651.15[医药卫生—外科学]