去骨瓣减压术治疗重型颅脑损伤患者发生急性脑膨出的影响因素  

Influencing factors of acute encephalocele in patients with severe craniocerebral injury treated by decompressive craniectomy

作　　者：周志刚 ZHOU Zhigang(Department of Neurosurgery of Pucheng County Hospital,Nanping 353400 Fujian,China)

机构地区：[1]福建省南平市浦城县医院神经外科,福建南平353400

出　　处：《中国民康医学》2024年第17期4-6,10,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:分析去骨瓣减压术治疗重型颅脑损伤患者发生急性脑膨出的影响因素。方法:回顾性分析2021年9月至2023年9月该院收治的92例行去骨瓣减压术治疗重型颅脑损伤患者的临床资料,统计急性脑膨出的发生情况,依据是否发生急性脑膨出将其分为发生组和未发生组。比较两组一般资料,采用多因素Logistic回归分析去骨瓣减压术治疗重型颅脑损伤患者发生急性脑膨出的影响因素。结果:去骨瓣减压术治疗重型颅脑损伤患者急性脑膨出的发生率为19.57%(18/92);发生组受伤至手术时间≥6 h、重要脏器组织损伤、术前格拉斯哥昏迷评分法(GCS)评分3~5分、弥漫性脑肿胀、术前低血氧症、脑干损伤等占比均高于未发生组,差异有统计学意义(P<0.05);多因素Logistic回归分析结果显示,受伤至手术时间≥6 h、重要脏器组织损伤、术前GCS评分3~5分、弥漫性脑肿胀、术前低血氧症、脑干损伤等均为影响去骨瓣减压术治疗重型颅脑损伤患者发生急性脑膨出的危险因素(OR>1,P<0.05)。结论:受伤至手术时间≥6 h、重要脏器组织损伤、术前GCS评分3~5分、弥漫性脑肿胀、术前低血氧症、脑干损伤等均为影响去骨瓣减压术治疗重型颅脑损伤患者发生急性脑膨出的危险因素。Objective:To analyze influencing factors of acute encephalocele in patients with severe craniocerebral injury treated by decompressive craniectomy.Methods:The clinical data of 92 patients with severe craniocerebral injury treated by decompressive craniectomy in this hospital from September 2021 to September 2023 were retrospectively analyzed.The occurrence of acute encephalocele was statistically analyzed.They were divided into occurrence group and non-occurrence group according to whether acute encephalocele occurred.The general data of the two groups were compared.Multivariate Logistic regression was used to analyze the influencing factors of acute encephalocele in the patients with severe craniocerebral injury treated with decompressive craniectomy.Results:The incidence of acute encephalocele in the patients with severe craniocerebral injury treated by decompressive craniectomy was 19.57%(18/92).The proportions of the time from injury to operation≥6 h,important organ tissue injury,preoperative Glasgow Coma Score(GCS)score of 3-5 points,diffuse cerebral swelling,preoperative hypoxemia and brainstem injury in the occurrence group were higher than those in the non-occurrence group,and the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that the time from injury to operation≥6 h,important organ tissue injury,preoperative GCS score 3-5 points,diffuse cerebral swelling,preoperative hypoxemia and brainstem injury were all risk factors for acute encephalocele in the patients with severe craniocerebral injury treated by decompressive craniectomy(OR>1,P<0.05).Conclusions:The time from injury to operation≥6 h,important organ tissue injury,preoperative GCS score 3-5 points,diffuse cerebral swelling,preoperative hypoxemia and brainstem injury are the risk factors for acute encephalocele in the patients with severe craniocerebral injury treated by decompressive craniectomy。

关 键 词：重型颅脑损伤 去骨瓣减压术 急性脑膨出 影响因素 

分 类 号：R651.15[医药卫生—外科学]