CAJ | 학술논문

目的：分析重型颅脑损伤患者术后并发脑积水的危险因素。方法选择重型颅脑损伤患者319例为研究对象。根据是否发生脑积水分为脑积水组(49例)和无脑积水组(270例)，分析患者术后发生脑积水的相关因素。结果脑积水组与无脑积水组患者的硬膜下及脑内血肿、开放性损伤、是否合并蛛网膜下腔出血、行去骨瓣减压术、硬膜敞开、腰穿脑脊液置换术比较，差异有统计学意义(P<0.05或P<0.01)。多因素Logistic回归分析显示，开放性损伤、蛛网膜下腔出血、去骨瓣减压术、硬膜敞开是重型颅脑损伤术后发生脑积水的危险因素(P<0.01)，而腰穿脑脊液置换术是保护因素(P<0.01)。结论开放性损伤、蛛网膜下腔出血、去骨瓣减压术、硬膜敞开是重型颅脑损伤患者术后发生脑积水的危险因素，腰穿脑脊液置换术是保护因素。
목적：분석중형로뇌손상환자술후병발뇌적수적위험인소。방법선택중형로뇌손상환자319례위연구대상。근거시부발생뇌적수분위뇌적수조(49례)화무뇌적수조(270례)，분석환자술후발생뇌적수적상관인소。결과뇌적수조여무뇌적수조환자적경막하급뇌내혈종、개방성손상、시부합병주망막하강출혈、행거골판감압술、경막창개、요천뇌척액치환술비교，차이유통계학의의(P<0.05혹P<0.01)。다인소Logistic회귀분석현시，개방성손상、주망막하강출혈、거골판감압술、경막창개시중형로뇌손상술후발생뇌적수적위험인소(P<0.01)，이요천뇌척액치환술시보호인소(P<0.01)。결론개방성손상、주망막하강출혈、거골판감압술、경막창개시중형로뇌손상환자술후발생뇌적수적위험인소，요천뇌척액치환술시보호인소。
Objective To analyze the influencing factors of postoperative hydrocephalus in patients with severe brain injury. Methods 319 cases of patients with severe brain injury were selected as subjects.All patients were divided into hydrocephalus group and non-hydrocephalus group according to whether with occurrence of hydrocephalus,and influ-encing factors of postoperative hydrocephalus in patients with severe brain injury were analyzed. Results Subdural and intracerebral hematoma,open injury,whether the merger subarachnoid hemorrhage,carried out decompressive craniecto-my,subdural open,lumbar puncture and cerebrospinal fluid replacement of hydrocephalus group and non-hydrocephalus group had significant difference (P<0.05 or P<0.01).Logistic analysis showed that,open injury,subarachnoid hemorrhage, decompressive craniectomy,subdural open were risk factors of postoperative hydrocephalus in patients with severe brain injury (P<0.01).Lumbar puncture and cerebrospinal fluid replacement was protecting factors (P<0.01). Conclusion Open injury,subarachnoid hemorrhage,decompressive craniectomy,subdural open are risk factors of postoperative hydro-cephalus in patients with severe brain injury,and lumbar puncture and cerebrospinal fluid replacement is protecting factors.