中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2014年
4期
307-310
,共4页
颅脑损伤%脑积水%减压术,外科
顱腦損傷%腦積水%減壓術,外科
로뇌손상%뇌적수%감압술,외과
Craniocerebral trauma%Hydrocephalus%Decompression,surgical
目的 研究去骨瓣减压术(decompressive craniectomy,DC)导致创伤后脑积水(post-traumatic hydrocephalus,PTH)的可能原因. 方法 回顾性分析62例因颅脑损伤行DC患者资料.根据术后是否并发脑积水,分为脑积水组(15例)和无脑积水组(47例),比较患者一般资料、术前病情、影像学表现、手术方法、手术参数,分析PTH发生的危险因素. 结果 两组患者在性别、年龄、ISS、瞳孔大小、瞳孔光反射、蛛网膜下腔出血Fisher分级、颅内占位体积、环池受压、中线移位、颅内感染、骨窗上缘距中线距离等方面差异无统计学意义;在是否行双侧去骨瓣(x2=9.235,P ＜0.05)、骨窗高度(t=3.751,P＜0.01)、骨窗面积(t=3.171,P＜0.01)、是否二次手术(x2=8.335,P＜0.01)方面差异有统计学意义.Logistic回归分析显示,双侧去骨瓣、骨窗高度及面积较大以及二次手术对患者DC后并发PTH具有显著影响. 结论 双侧去骨瓣、骨窗高度较大、骨窗面积较大和二次手术是DC后并发PTH的危险因素.
目的 研究去骨瓣減壓術(decompressive craniectomy,DC)導緻創傷後腦積水(post-traumatic hydrocephalus,PTH)的可能原因. 方法 迴顧性分析62例因顱腦損傷行DC患者資料.根據術後是否併髮腦積水,分為腦積水組(15例)和無腦積水組(47例),比較患者一般資料、術前病情、影像學錶現、手術方法、手術參數,分析PTH髮生的危險因素. 結果 兩組患者在性彆、年齡、ISS、瞳孔大小、瞳孔光反射、蛛網膜下腔齣血Fisher分級、顱內佔位體積、環池受壓、中線移位、顱內感染、骨窗上緣距中線距離等方麵差異無統計學意義;在是否行雙側去骨瓣(x2=9.235,P ＜0.05)、骨窗高度(t=3.751,P＜0.01)、骨窗麵積(t=3.171,P＜0.01)、是否二次手術(x2=8.335,P＜0.01)方麵差異有統計學意義.Logistic迴歸分析顯示,雙側去骨瓣、骨窗高度及麵積較大以及二次手術對患者DC後併髮PTH具有顯著影響. 結論 雙側去骨瓣、骨窗高度較大、骨窗麵積較大和二次手術是DC後併髮PTH的危險因素.
목적 연구거골판감압술(decompressive craniectomy,DC)도치창상후뇌적수(post-traumatic hydrocephalus,PTH)적가능원인. 방법 회고성분석62례인로뇌손상행DC환자자료.근거술후시부병발뇌적수,분위뇌적수조(15례)화무뇌적수조(47례),비교환자일반자료、술전병정、영상학표현、수술방법、수술삼수,분석PTH발생적위험인소. 결과 량조환자재성별、년령、ISS、동공대소、동공광반사、주망막하강출혈Fisher분급、로내점위체적、배지수압、중선이위、로내감염、골창상연거중선거리등방면차이무통계학의의;재시부행쌍측거골판(x2=9.235,P ＜0.05)、골창고도(t=3.751,P＜0.01)、골창면적(t=3.171,P＜0.01)、시부이차수술(x2=8.335,P＜0.01)방면차이유통계학의의.Logistic회귀분석현시,쌍측거골판、골창고도급면적교대이급이차수술대환자DC후병발PTH구유현저영향. 결론 쌍측거골판、골창고도교대、골창면적교대화이차수술시DC후병발PTH적위험인소.
Objective Objective To determine the potential factors for development of post-traumatic hydrocephalus (PTH) after decompressive craniectomy (DC).Methods A retrospective study was performed on 62 patients undergone DC after craniocerebral trauma.Based on the incidence of hydrocephalus after DC,the patients were divided into hydrocephalus group (n =15) and non-hydrocephalus group (n =47).The factors including general data information,pre-operative condition,imagine manifestation,operation methods,and surgical parameters were compared between groups to identify the risk factors contributing to the development of PTH.Results No statistical differences were found between the two groups in aspects of gender,age,injury severity score (ISS),pupillary size,pupillary light reflex,Fisher scale of subarachnoid hemorrhage,volume of intracranial occupation,ambient cistern compression,midline shift,intracranial infection,and distance of superior margin of the craniectomy to midline.But there were significant differences of the two groups in whether underwent bilateral craniectomy (x2 =9.235,P ＜0.05),height of craniectomy (t =3.751,P ＜ 0.01),area of craniectomy (t =3.171,P ＜ 0.01) and whether underwent reoperation (x2 =8.335,P ＜ 0.01).Logistic regression analysis indicated that the development of PTH was significantly affected by bilateral craniectomy,large craniectomy and reoperation.Conclusion Bilateral craniectomy,large craniectomy and reoperation are risk factors for the development of PTH after DC.
