颅脑损伤患者术后对侧硬膜外血肿发生的影响因素研究  

The influencing factors of the contralateral epidural hematoma in patients with craniocerebral injury after operation

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23期120-122,共3页Contemporary Medicine

摘　　要：目的分析颅脑损伤患者术后对侧硬膜外血肿发生的影响因素。方法回顾性分析2019年3月至2021年2月宜春市第二人民医院收治的40例术后发生对侧硬膜外血肿的颅脑损伤患者作为发生组,另选取同期术后40例未发生对侧硬膜外血肿的颅脑损伤患者作为未发生组。查阅患者基线资料,纳入可能的影响因素,Logistic回归分析颅脑损伤患者术后对侧硬膜外血肿发生的影响因素。结果发生组脑中线偏移≥1 cm占比、发生颅脑骨折占比、去骨瓣减压术率、凝血酶时间(TT)高于未发生组,差异有统计学意义(P<0.05);两组年龄、性别、受伤机制、手术时间比较差异无统计学意义。Logistic回归分析显示,术前脑中线偏移≥1 cm、颅骨骨折、去骨瓣减压术、TT延长是颅脑损伤患者术后对侧硬膜外血肿发生的危险因素(OR>0,P<0.05)。结论颅脑损伤患者术后对侧硬膜外血肿发生受脑中线偏移≥1 cm、颅骨骨折、去骨瓣减压术、TT延长等因素影响。Objective To analyze the influencing factors of contralateral epidural hematoma in patients with craniocerebral injury after operation.Methods 40 patients with craniocerebral injury who had contralateral epidural hematoma after operation in Yichun Second People's Hospital from March 2019 to February 2021 were collected and included in the occurrence group,another 40 patients with craniocerebral injury who did not have contralateral epidural hematoma after operation in the same period were collected and included in the non occurrence group.The baseline data of patients were reviewed,the possible influencing factors were included,Logistic regression analysis was used to find out the influencing factors of contralateral epidural hematoma in patients with craniocerebral injury after operation.Results The incidence of brain midline deviation≥1 cm,the incidence of skull fracture,the rate of decompressive craniectomy and thrombin time(TT)in the occurrence group were higher than those in the nonoccurrence group,and the differences were statistically significant(P<0.05);there were no significant difference in age,sex,injury mechanism and operation time between the two groups.Logistic regression analysis showed that preoperative brain midline deviation≥1 cm,skull fracture,decompressive craniectomy,prolongation of TT were risk factors for contralateral epidural hematoma in patients with craniocerebral injury after operation(OR>0,P<0.05).Conclusion The occurrence of contralateral epidural hematoma in patients with craniocerebral injury after operation is related to preoperative brain midline deviation≥1 cm,skull fracture,decompressive craniectomy,prolongation of TT.

关 键 词：颅脑损伤 硬膜外血肿 颅骨骨折 去骨瓣减压术 凝血酶时间 

分 类 号：R651.15[医药卫生—外科学]