创伤性脑损伤并发脑积水的危险因素

Risk Factors of Hydrocephalus after Traumatic Brain Injury

目的 探讨中、重型创伤性脑损伤（TBI）后脑积水的发生率和危险因素。方法分析394例中、重度TBI息者，探讨性别、年龄、入院时GCS评分、开颅去骨瓣减压术，以及是否伴有脑室出血和弥漫性蛛网膜下腔出血等，对创伤后脑积水发生的影响。结果394例中、重型TBI患者中，33例（8．38％）发生脑积水，时间在伤后2～4周；高龄患者创伤后脑积水的发生率明显增加（P〈0．01）；脑积水与开颅去骨瓣减压术、脑室出血和弥漫性蛛网膜下腔出血等有关（P〈0．01）。结论高龄患者、开颅去骨瓣减压术、脑室出血和弥漫性蛛网膜下腔出血是创伤后脑积水发生的危险因素。

Objective To detect the risk factors of hydrocephalus in patients with moderate or severe traumatic brain injury（TBI）. Methods Three hundred and ninety-four patients with moderate or severe TBI were retrospectively reviewed to determine the effects of age, sex, admission GCS scores, decompressive craniotomy, intraventricular hemorrhage and subarachnoid hemorrhage on the development of hydrocephalus. Results Thirty-three patients （8.38%） with moderate or severe TBI underwent hydrocephalus, and the majority were developed in the duration of 2 to 4 weeks after brain injury. Our study found a high incidence of post-traumatic hydrocephalus in the elderly patients（P 〈0.01）. The incidence of hydrocephalus was closely related to the admission GCS scores, intraventricular hemorrhage, subarachnoid hemorrhage and decompressive craniotomy （P 〈 0.01 ）. Conclusion Elderly patients, decompressive craniotomy, intraventricular hemorrhage, and subarachnoid hemorrhage could be risk factors for hydrocephalus.