去骨瓣减压术后创伤后脑积水发生的影响因素  

Influencing factors for posttraumatic hydrocephalus after decompressive craniectomy

作　　者：祁海晖 宋孟若 徐亚[1] 朱卫国[1] 桂群峰 陈华群[1] QI Haihui;SONG Mengruo;XU Ya(Department of Neurosurgery,Yancheng Third People's Hospital,Yancheng 224000,CHINA)

机构地区：[1]盐城市第三人民医院神经外科,江苏224000

出　　处：《江苏医药》2023年第12期1259-1262,共4页Jiangsu Medical Journal

摘　　要：目的分析颅脑外伤患者去骨瓣减压术后创伤后脑积水(PTH)发生的影响因素。方法回顾性分析126例行去骨瓣减压术治疗的颅脑外伤患者的临床资料,采用多因素logistic回归分析术后PTH发生的影响因素。结果126例颅脑外伤患者中,术后发生PTH(PTH组)21例,未发生PTH(非PTH组)105例。PTH组行双侧去骨瓣、术前合并脑室出血、术前合并蛛网膜下腔出血、术后并发硬膜下积液和骨瓣边缘至中线距离<20 mm患者比例高于非PTH组(P<0.05)。多因素logistic回归分析结果显示,术前合并脑室出血、术前合并蛛网膜下腔出血和骨瓣边缘至中线距离<20 mm是颅脑外伤患者术后PTH发生的独立危险因素(P<0.05)。结论颅脑外伤行去骨瓣减压术治疗的患者术前合并脑室出血、蛛网膜下腔出血及手术骨瓣距离中线过近是PTH发生的独立危险因素。Objective To analyze the influencing factors for the occurrence of posttraumatic hydrocephalus(PTH)after decompressive craniectomy in the patients with craniocerebral trauma.Methods The clinical data of 126 patients with craniocerebral trauma underwent decompressive craniectomy were retrospectively analyzed.The influencing factors for the occurrence of PTH after decompressive craniectomy were analyzed by multivariate logistic regression.Results Of 126 patients with craniocerebral trauma,PTH after decompressive craniectomy occurred in 21 cases(group A),which did not happen in 105 cases(group B).The percentages of the patients with bilateral decompressive craniectomy,ventricular hemorrhage before operation,subarachnoid hemorrhage before operation,subdural effusion after operation and the distance from edge to midline of bone flap<20 mm in group A were higher than those in group B(P<0.05).The multivariate logistic regression analysis showed that ventricular hemorrhage before operation,subarachnoid hemorrhage before operation and distance from edge to midline of bone flap<20 mm were the independent risk factors for the occurrence of PTH after decompressive craniectomy in the patients with craniocerebral trauma(P<0.05).Conclusion In the patients with craniocerebral trauma,the ventricular hemorrhage,subarachnoid hemorrhage before operation and the distance from edge to midline of bone flap<20 mm are the independent risk factors for the occurrence of PTH after decompressive craniectomy.

关 键 词：颅脑外伤 创伤后脑积水 去骨瓣减压术 

分 类 号：R651[医药卫生—外科学]