重度颅脑损伤患者颅内血肿清除术后发生对侧硬膜外血肿的危险因素分析  

Risk factors of contralateral epidural hematoma after removal of intracranial hematoma for severe craniocerebral injury

作　　者：张涛[1] 孙含蓄[1] 孙世远[1] Zhang Tao;Sun Hanxu;Sun Shiyuan(Department of Neurosurgery I,Nanyang First People’s Hospital,Nanyang 473000,China)

机构地区：[1]南阳市第一人民医院神经外一科,南阳473000

出　　处：《中国实用医刊》2022年第20期17-20,共4页Chinese Journal of Practical Medicine

摘　　要：目的探究重度颅脑损伤患者颅内血肿清除术后发生对侧硬膜外血肿的危险因素。方法抽取2019年1月至2021年12月南阳市第一人民医院收治的150例20~50岁经颅内血肿清除术治疗的重度颅脑损伤患者作为研究对象。对患者术后情况进行跟踪随访记录,依据术后是否出现对侧硬脑膜外血肿将其分为发生组(30例)与未发生组(120例)。整理两组患者的基本资料,采用Logistic回归分析法分析影响重度颅脑损伤患者颅内血肿清除术后并发对侧硬膜外血肿的相关因素。结果两组患者脑挫裂伤、颅骨骨折、手术介入时机以及手术方式等基线资料比较,差异有统计学意义(P<0.05);其他基线资料比较差异未见统计学意义(P>0.05)。Logistic回归分析结果显示,手术介入时机、手术方式、是否为脑挫裂伤、颅骨是否出现骨折是影响重度颅脑损伤患者血肿清除术后并发出现对侧硬膜外血肿的相关因素(OR=2.520、2.852、2.683、2.843,P均<0.05)结论手术介入时机、手术方式、脑挫裂伤以及颅骨骨折是引起重度颅脑损伤患者术后并发对侧硬膜外血肿的重要危险因素。Objective To investigate the risk factors of contralateral epidural hematoma after removal of intracranial hematoma for severe craniocerebral injury.Methods A total of 150 patients aged 20 to 50 years with severe craniocerebral injury who were treated by intracranial hematoma removal in Nanyang First People’s Hospital from January 2019 to December 2021 were selected as the research objects.Patients were followed up to record the postoperative conditions,and they were divided into occurrence group(30 cases)and non occurrence group(120 cases)according to occurrence of contralateral epidural hematoma after operation.The general data of patients in the two groups were sorted,and the related factors affecting the contralateral epidural hematoma after removal of intracranial hematoma in patients with severe craniocerebral injury were analyzed by Logistic regression analysis.Results There were differences in general data including brain contusion and laceration,skull fractures,the timing of surgical intervention and operation method between the two groups(P<0.05).There was no significant difference in other general data between the two groups(P>0.05).Results of Logistic regression analysis showed that timing of surgical intervention,surgery method,occurrence of brain contusion and laceration,skull fractures were influencing factors of contralateral epidural hematoma after removal of intracranial hematoma in patients with severe craniocerebral injury(OR=2.520,2.852,2.683,2.843;all P<0.05).Conclusions The influencing factors of contralateral epidural hematoma after removal of intracranial hematoma in patients with severe craniocerebral injury includes timing of surgical intervention,operation method,brain contusion and laceration,and skull fractures.

关 键 词：重度颅脑损伤 血肿清除术 对侧硬膜外血肿 手术介入时机 颅骨骨折 脑挫裂伤 骨瓣 

分 类 号：R651.15[医药卫生—外科学]