颅骨修补术后癫痫发作的临床特点及相关因素Logistic分析  

The logistic analysis of clinical characteristics and related factors of epileptic seizures after skull repair surgery

作　　者：张李涛[1] 沈健[1] 褚闻来 官俏兵[1] 沈和平[1] 王耿焕[1] 褚正民[1] Zhang Litao

机构地区：[1]嘉兴学院附属第二医院,314099 [2]浙江省荣军医院,314009

出　　处：《浙江临床医学》2023年第12期1764-1766,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省医药卫生科技计划项目(2022KY1257);浙江省医学会临床科研基金项目(2021ZYC-A150);嘉兴市科技计划项目(2023AD31031)。

摘　　要：目的探索颅骨修补术后癫痫发作的临床特点及相关因素。方法回顾性分析2009年1~12月嘉兴学院附属第二医院神经外科收治的470例颅骨修补术患者的临床资料,术后随访1~10年,按术后癫痫发作情况,分为癫痫发作组和无癫痫发作组,比较两组患者各种因素的差异,以分析癫痫发作的影响因素。结果470例患者中颅骨修补术后出现癫痫发作76例(16.2%)。单因素分析显示,皮瓣凹陷、大骨瓣、术前昏迷、双侧修补、围手术期使用抗癫痫药物差异有统计学意义(P<0.05)。多因素Logistic分析显示皮瓣凹陷、大骨瓣、围手术期使用抗癫痫药物差异有统计学意义(P<0.05)。结论皮瓣凹陷、大骨瓣是颅骨修补术后癫痫发作的危险因素,围手术期使用抗癫痫药物是保护因素,对于皮瓣凹陷太深的患者,建议早期行颅骨修补术,可考虑适当降低三维弧度,同时予围手术期使用抗癫痫药物。Objective To explore the clinical characteristics and related factors of epileptic seizures after cranioplasty.Methods The clinical data of 470 patients with cranioplasty from January 2009 to December 2019 in our hospital were retrospectively analyzed.All patients were followed up for 1 to 10 years.According to whether seizure happened after cranioplasty,they were divided into the seizure group and the no seizure group.The differences of various factors between the two groups were compared in order to explore the influencing factors of epileptic seizures.Results Of the 470 patients,76 cases(16.2%)had epileptic seizures after cranioplasty.Univariate analysis showed that skin flap depression,large bone flap,preoperative coma,bilateral cranioplasty,and perioperative use of antiepileptic drugs were statistically significant(P<0.05).Logistic analysis showed that skin flap depression,large bone flaps,and the use of antiepileptic drugs during the perioperative period were statistically different(P<0.05).Conclusion Skin flap depression,large bone flap are risk factors for epileptic seizures after cranioplasty.The use of antiepileptic drugs during the perioperative period is a protective factor.For patients whose skin flaps are too deeply sunken,early cranioplasty is recommended and the three-dimensional radian can be reduced appropriately.At the same time,antiepileptic drugs should be used in the perioperative period.

关 键 词：颅骨修补 癫痫发作 危险因素 

分 类 号：R651.1[医药卫生—外科学]