颅脑外伤手术后继发癫痫的危险因素分析  

The risk analysis of the secondary epilepsy after craniocerebral trauma surgery

作　　者：葛志强 许悦[1] 徐清[1] 冯晓东[1] 王伟[1] Ge Zhiqiang

机构地区：[1]江苏省太仓市第一人民医院,215413

出　　处：《浙江临床医学》2021年第12期1742-1743,1746,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨颅脑外伤手术后继发癫痫的危险因素,为术后个体化抗癫痫治疗提供参考。方法固顾性分析2017年1月至2018年12月在本院行颅脑外伤手术的患者147例,采用单因素及多因素logistic回归分析颅脑术后继发癍痫的相关因素。结果颅脑外伤手术后发生癫痫29例(19.73%)。单因素及多因素logistic回归分析显示,脑挫裂伤(包含脑内血肿)、二次手术和颅内感染均是颅脑术后继发癫痫的高危因素(P<0.05)。术前GCS评分低的患者癫痫发生率高于GCS评分高者(P<0.05),制作受试者工作特征曲线(ROC)确定其最佳临界值为9.5。结论颅脑外伤术后继发癫痫的几率较高,尤其是脑挫裂伤(包含脑内血肿)、二次手术和颅内感染的患者术后应加强预防癫痫治疗,术前GCS低于9分的患者更应警惕术后癫痫的发生。Objective To investigate the risk factors of secondary epilepsy after craniocerebral trauma surgery,and to provide reference for postoperative individualized antiepileptic treatment.Methods A retrospective analysis was performed on 147 patients who underwent craniocerebral trauma surgery in our hospital from January 2017 to December 2018.Univariate and multivariate Logistic regression were used to analyze the related factors of secondary epilepsy after craniocerebral surgery.Results Epilepsy occurred in 29 cases(19.73%)after craniocerebral trauma operation.Univariate and multivariate logistic regression analysis showed that brain contusion(including intracerebral hematoma),secondary surgery and intracranial infection were all high risk factors of secondary epilepsy after craniocerebral surgery(P<0.05).The incidence of epilepsy in parients with low preoperative GCS score was higher than that in patients with high preoperarive GCS score(P<0.05),and the optimal threshold was determined by receiver operating characteristic curve(ROC)at 9.5.Conclusion There is a high probability of secondary epilepsy after craniocerebral trauma,especially for patients with brain contusion(including intracerebral hematoma),secondary surgery and intracranial infection,preventive epilepsy treatment should be strengthened after surgery,and patients with preoperative GCS lower than 9 points should be more alert to the occurrence of postoperative epilepsy.

关 键 词：颅脑外伤手术 继发性癫痫 危险因素 

分 类 号：R74[医药卫生—神经病学与精神病学]