重型颅脑外伤去骨瓣减压术后并发症的临床分析

发布时间：2018-03-09 16:31

本文选题：重型颅脑外伤　切入点：去骨瓣减压术　出处：《广西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨重型颅脑外伤去骨瓣减压后并发术症的发生机制、危险因素及其对预后的影响,为重型颅脑外伤去骨瓣减压术后并发症的预防和诊治提供依据。方法:回顾性分析2014年6月至2016年6月间期在广西医科大学第一附属医院神经外科收治的95例行去骨瓣减压术的重型颅脑外伤患者。收集和分析他们的相关临床料:性别、年龄、病因、病史、入院GCS评分、体征、影像学资料和预后情况。结果:95例患者中,男性患者77例(81.05%),女性患者18例(18.94%),年龄范围6-77岁,平均年龄45.42岁。最常见的病因为交通事故56例(58.95%)。去骨瓣减压术后出现并发症30例(31.58%),其中最常见的并发症是硬膜下积液18例(18.95%),迟发性颅内出血死亡率最高。单因素分析包括:年龄、入院GCS评分、血肿位置、术前瞳孔变化、中线移位与并发症的发生密切相关;Logistics回归分析提示患者年龄、术前瞳孔散大、血肿位置、中线移位是重型颅脑外伤去骨瓣减压术后并发症的独立危险因素。结论:重型颅脑外伤去骨瓣减压术后并发症的发生常见,迟发性颅内出血严重影响患者预后,术后应严密观察,做到及早发现及早处理。患者年龄越大、颅脑外伤越严重,术后并发症的发生率越高。
[Abstract]:Objective: To investigate the mechanism of concurrent operation of severe craniocerebral trauma in decompressive craniectomy, risk factors and prognosis of, provide the basis for prevention and treatment of complications after decompressive craniectomy for severe traumatic brain injury. Methods: a retrospective analysis from June 2014 to June 2016 in the First Affiliated Hospital of Guangxi Medical University, Department of neurosurgery treated 95 cases. Bone flap decompression in patients with severe craniocerebral trauma. The collection and analysis of relevant clinical data: gender, age, their causes, history, admission GCS score, signs, imaging data and prognosis. Results: in 95 cases, 77 cases of male patients (81.05%), 18 cases of female patients (18.94%), age range 6-77 years old, the average age is 45.42 years old. The most common disease because of traffic accident in 56 cases (58.95%). Complications after decompressive craniectomy in 30 cases (31.58%), one of the most common complications of 18 cases of subdural effusion (1 8.95%), delayed intracranial hemorrhage mortality was highest. Univariate analysis: age, admission GCS score, hematoma location, change of pupil before surgery, and midline complications are closely related; Logistics regression analysis showed that age, preoperative mydriasis, location of hematoma, midline shift were independent risk factors of severe craniocerebral injury after decompressive craniectomy complications. Conclusion: the occurrence of severe traumatic brain injury after decompressive craniectomy common complications, delayed intracranial hemorrhage seriously affect the prognosis of patients, close observation after surgery, do early detection early treatment. The patients who were older, more serious craniocerebral trauma, postoperative complication rate is high.

【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R651.15

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