创伤性颅脑损伤患者保守治疗发生脑积水的危险因素分析  

Risk factors analysis for hydrocephalus occurring in patients with traumatic brain injury treated conservatively

作　　者：聂玉金 曹培成 Nie Yujin;Cao Peicheng(School of Clinical Medicine,Shandong Second Medical University,Weifang 261021,China;Department of Neurosurgery,The First Affiliated Hospital of Shandong Second Medical University,Weifang 261021,China)

机构地区：[1]山东第二医科大学临床医学院,潍坊261021 [2]山东第二医科大学第一附属医院神经外科,潍坊261021

出　　处：《中华神经创伤外科电子杂志》2023年第6期355-359,共5页Chinese Journal Of Neurotraumatic Surgery：Electronic Edition

摘　　要：目的探讨创伤性颅脑损伤(TBI)患者保守治疗后发生创伤性脑积水(PTH)的危险因素。方法选取山东第二医科大学第一附属医院神经外科自2018年6月至2021年11月收治的168例行保守治疗的TBI患者作为研究对象,根据治疗后是否发生PTH将患者分为PTH组和非PTH组,比较2组患者的临床资料,并采用多因素Logistic回归模型分析PTH发生的危险因素。结果168例PTH患者中,PTH组46例,非PTH组122例。2组患者的年龄、创伤性蛛网膜下腔出血、脑室出血、入院GCS评分、颅内感染比较,差异有统计学意义(P<0.05);进一步采用多因素Logistic回归分析显示,年龄≥56岁、创伤性蛛网膜下腔出血、脑室出血、入院时GCS评分<12分、颅内感染为TBI保守治疗后PTH发生的独立危险因素(P<0.05)。结论年龄≥56岁、创伤性蛛网膜下腔出血、脑室出血、入院时GCS评分<12分、颅内感染为TBI保守治疗后PTH发生的独立危险因素,临床应采取针对性的预防及治疗措施,以降低PTH的发生几率,改善患者的预后。Objective To investigate the risk factors for the occurrence of posttraumatic hydrocephalus(PTH)in patients with traumatic brain injury(TBI)treated conservatively.Methods From June 2018 to November 2021,168 patients with TBI admitted to Neurosurgery Department of the First Affiliated Hospital of Shandong Second Medical University under conservative treatment were selected as the subjects of this study.Patients were divided into PTH group and non-PTH group based on whether PTH occurred after treatment.The clinical data of the two groups of patients were compared,and the multivariate Logistic regression model was used to analyze the risk factors for PTH occurrence.Results Among 168 patients,46 cases of PTH occurred(PTH group),122 cases of non occurring PTH(non-PTH group).There was a statistically significant difference in age,traumatic subarachnoid hemorrhage,ventricular hemorrhage,admission GCS score,and intracranial infection between the two groups of patients(P<0.05);Further multivariate Logistic regression analysis showed that age≥56 years,traumatic subarachnoid hemorrhage,intraventricular hemorrhage,GCS<12 score on admission,and intracranial infection were independent risk factors for PTH after conservative treatment with TBI(P<0.05).Conclusion Age≥56 years old,traumatic subarachnoid hemorrhage,intraventricular hemorrhage,GCS<12 score at admission,and intracranial infection are independent risk factors for PTH after conservative treatment of TBI.Targeted prevention and treatment measures should be taken clinically to reduce the incidence of PTH and improve patient prognosis.

关 键 词：创伤性脑积水 创伤性颅脑损伤 保守治疗 危险因素 

分 类 号：R651.15[医药卫生—外科学]