颅脑损伤神经外科治疗后硬膜下积液的影响因素分析  

Influencing Factors Analysis of Subdural Effusion of Traumatic Brain Injury after Neurosurgical Treatment

作　　者：张继鑫 李仁涛 ZHANG Jixin;LI Rentao(Jinan City Jiyang District People's Hospital,Jinan,Shandong,251400)

机构地区：[1]山东省济南市济阳区人民医院,山东济南251400

出　　处：《智慧健康》2024年第21期71-74,共4页Smart Healthcare

摘　　要：目的 探讨颅脑损伤患者经外科治疗后硬膜下积液形成的影响因素。方法 选取2020年2月—2023年2月本院收治的149例颅脑损伤患者临床资料进行回顾性分析,所有患者均实施去骨瓣减压术治疗,其中治疗后有47例形成硬膜下积液(积液组),102例未形成硬膜下积液(非积液组),对神经外科治疗后硬膜下积液形成的危险因素实施单因素和多因素Logistic回顾分析。结果 两组患者入院时格拉斯哥昏迷记分(GCS)评分、血肿量、血肿位置、基底池受压、手术时机、脑积水及蛛网膜下腔出血发生率、中线结构位移≥10mm差异有统计学意义(P<0.05);经Logistic多因素分析发现,入院时GCS评分≤5分、血肿量>40mL、基底池受压、脑积水、蛛网膜下腔出血、中线结构位移≥10mm是造成颅脑损伤神经外科治疗后硬膜下积液形成的独立危险因素。结论 颅脑损伤神经外科治疗后硬膜下积液的形成受到多个因素的影响,包括入院时的GCS评分、血肿量、血肿位置、基底池受压、手术时机、脑积水和蛛网膜下腔出血发生率以及中线结构位移等。这些因素的评估和管理对于降低硬膜下积液的形成风险和提高治疗效果至关重要。Objective To explore influencing factors of subdural effusion formation of patients with traumatic brain injury after surgical treatment.Methods The paper reviewed and analyzed clinical data of 149 traumatic brain injury patients treated with decompressive craniectomy in our hospital from February 2020 to February 2023.Among them,47 cases developed subdural effusion(effusion group)and 102 cases had no subdural effusion(non effusion group)after treatment.Single factor and multiple factor logistic retrospective analysis was carried out for risk factors of subdural effusion formation after neurosurgical treatment.Results There was significant difference in Glasgow Coma Scale(GCS)scores,hematoma volume,hematoma location,basal cistern compression,surgical timing,incidence of hydrocephalus and subarachnoid hemorrhage,and midline structural displacement≥10mm between two groups,(P<0.05).Logistic multivariate analysis found,independent risk factors of subdural effusion of traumatic brain injury after neurosurgical treatment included GCS scores≤5 points,hematoma volume>40mL,basal cistern compression,hydrocephalus,subarachnoid hemorrhage,and midline structural displacement≥10mm.Conclusion Subdural effusion of traumatic brain injury after neurosurgical treatment is influenced by multiple factors,including admission GCS scores,hematoma volume,hematoma location,basal cistern compression,surgical timing,incidence of hydrocephalus and subarachnoid hemorrhage,and midline structural displacement.Evaluation and management of above factors are crucial for reducing risks of subdural fluid formation and improving treatment outcomes.

关 键 词：颅脑损伤 神经外科 去骨瓣减压术 硬膜下积液 影响因素 

分 类 号：R651.15[医药卫生—外科学]