颅脑外伤去骨瓣减压术后继发硬膜下积液的危险因素分析

发布时间：2018-06-06 03:23

本文选题：颅脑外伤 + 去骨瓣减压　；参考：《国际神经病学神经外科学杂志》2017年05期

【摘要】：目的分析颅脑外伤去骨瓣减压术后继发性硬膜下积液的危险因素。方法回顾性分析我院2014年1月至2016年6月间的138例颅脑外伤去骨瓣减压术患者的临床资料和影像学资料。根据术后是否发生硬膜下积液分为积液组和非积液组,通过单因素t检验、卡方检验和多因素Logistic回归分析总结颅脑外伤去骨瓣减压术后发生硬膜下积液的影响因素。结果 138例患者中,85例患者发生硬膜下积液,发生率为61.6%。单因素分析结果显示两组患者在性别、年龄、术前GCS评分、环池受压、术前是否合并脑疝、硬膜外血肿、脑内血肿、脑室内出血、蛛网膜下腔出血、骨瓣的前后径大小、骨瓣的最高径大小、去骨瓣减压的侧别均无统计学意义(p0.05)。去骨瓣减压术后硬膜下积液和中线移位大于5 mm、皮层切开、硬膜下血肿、骨瓣边缘距中线距离小于2 mm有明显关联。多因素分析结果显示只有中线移位大于5 mm和皮层切开是危险因素。结论颅脑外伤去骨瓣减压术后继发性硬膜下积液和中线移位大于5mm、皮层切开有明显关联,应引起重视。
[Abstract]:Objective to analyze the risk factors of secondary subdural effusion after craniocerebral trauma. Methods the clinical and imaging data of 138 patients with craniocerebral trauma undergoing decompression of craniocerebral trauma from January 2014 to June 2016 were retrospectively analyzed. Subdural effusion was divided into two groups according to whether there was subdural effusion after operation. The influencing factors of subdural effusion after decompression of craniocerebral trauma were summarized by single factor t test, chi-square test and multivariate Logistic regression analysis. Results Intradural effusion was found in 85 of 138 patients (61.6%). The results of univariate analysis showed that the two groups had sex, age, preoperative GCS score, pressure of the ring cistern, whether the hernia, epidural hematoma, intracerebral hematoma, intraventricular hemorrhage, subarachnoid hemorrhage, anterior and posterior diameter of the bone flap were involved. The maximum diameter of bone flap and the side of decompression without bone flap had no statistical significance (P 0.05). The displacement of subdural effusion and midline was more than 5 mm after decompression of bone flap. The cortical incision and subdural hematoma were significantly related to the distance between the margin of bone flap and the midline of bone flap less than 2 mm. Multivariate analysis showed that only midline displacement greater than 5 mm and cortical incision were risk factors. Conclusion the displacement of secondary subdural effusion and midline after craniocerebral trauma decompression is greater than 5 mm, and cortical incision has a significant correlation, which should be paid more attention to.
【作者单位】：常州市武进人民医院神经外科;
【分类号】：R651.15

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