重症颅脑损伤患者开颅手术后切口愈合不良发生的影响因素的研究  

Study on the influencing factors of poor wound healing after craniotomy in patients with severe craniocerebral injury

作　　者：付杰平 王敏 FU Jieping;WANG Min(Department of Neurosurgery,Yichun Second People's Hospital,Yichun,Jiangxi,336000,China)

机构地区：[1]宜春市第二人民医院神经外科,江西宜春336000

出　　处：《当代医学》2023年第22期167-169,共3页Contemporary Medicine

摘　　要：目的分析重症颅脑损伤患者开颅手术后发生切口愈合不良的影响因素。方法回顾性选取2018年4月至2021年4月宜春市第二人民医院收治的40例重症颅脑损伤经开颅手术后发生切口愈合不良的患者作为发生组;另收集本院同期收治的重症颅脑损伤经开颅手术后未发生切口愈合不良的40例患者作为未发生组。查阅并记录患者临床资料,将可能的影响因素纳入,Logistic回归分析重症颅脑损伤患者开颅手术后切口愈合不良发生的影响因素。结果发生组切口缝针距离较近、创面感染占比高于未发生组,切口长度长于未发生组,差异有统计学意义(P<0.05);两组性别、年龄、颅脑损伤原因、体重指数(BMI)、手术时间、术中出血量、头皮缝合方式、术后抗生素使用时间、切口安乐碘湿敷、术后1周白蛋白含量比较差异无统计学意义。Logistic回归分析显示,切口缝针距离较近、切口长度较长、创面感染是重症颅脑损伤患者开颅手术后切口愈合不良发生的影响因素。结论重症颅脑损伤患者经开颅手术后发生切口愈合不良可能与切口缝针距离较近、切口长度较长、创面感染相关,临床可据此制订针对性预防方案,以降低术后切口愈合不良风险。Objective To analyze the influencing factors of poor wound healing after craniotomy in patients with severe craniocerebral injury.Methods 40 patients with severe craniocerebral injury suffering from poor incision healing after craniotomy admitted to the Second People's Hospi-tal of Yichun City from April 2018 to April 2021 were selected as the occurrence group;in addition,the 40 patients with severe craniocerebral injury treated in our hospital during the same period without poor wound healing after craniotomy were selected as the non occurrence group.The clinical data of patients were reviewed and recorded,the possible influencing factors were included,Logistic regression was used to analyze the influencing factors of poor wound healing after craniotomy in patients with severe craniocerebral injury.Results The proportion of closer stitching distance of incision and wound infection in the occurrence group was higher than the non occurrence group,and the incision length was longer than that in the non occurrence group,the differences were statistically significant(P<0.05).There were no significant differences in gender,age,cause of cranioce-rebral injury,body mass index(BMI),operation time,intraoperative blood loss,scalp suturing method,postoperative antibiotic use time,incision io-dine wet compress,and albumin content 1 week after surgery between the two groups.Logistic regression analysis showed that short incision suture needle distance,long incision length and wound infection were the influencing factors of poor incision healing after craniotomy in patients with se-vere craniocerebral injury.Conclusion The poor wound healing after craniotomy in patients with severe craniocerebral injury may be related to clos-er stitching distance of incision,longer incision length and wound infection.,therefore,targeted prevention programs can be developed clinically to reduce the risk of poor wound healing after surgery.

关 键 词：颅脑损伤 开颅手术 切口愈合 缝针距离 创面感染 切口长度 

分 类 号：R651.15[医药卫生—外科学]