颅脑损伤去骨瓣减压术后慢性脑积水

Postoperative hydrocephalus in traumatic patients undergoing decompressive hemicraniectomy

目的探讨创伤后去骨瓣减压的类型及是否二次手术对脑积水发生的影响。方法回顾性分析387例中、重型颅脑损伤手术病人。结果去骨瓣减压病人脑积水发生率为27.0%,保留骨瓣的病人脑积水发生率为3.8%,双侧开颅、二次手术增大脑积水的发生率,骨瓣距中线距离越近越容易发生脑积水结论去骨瓣减压手术和创伤后脑积水有明确的相关关系,骨瓣相对较大、二次手术及骨瓣距离中线近和脑积水的形成有关。

Objective To determine if the type of craniectomy and repeated operation can contribute to posttraumatic hydrocephalus（PTH）. Methods The clinical data of 387 moderate and severe head trauma patients admitted to our hospital and underwent operation were analyzed trospeetively. Results 47 （27.0%） developed PTH in 174 patients underwent decompressive cranieetomy（DC） and 8 （3.8%） developed PTH without DC. Significant differences among the types of craniectomy and re-operation and distance from central line. Conclusion There is a strong correlation between DC and incidence of hydrocephalus, the large of DC and repeated operation may promote posttraumatic hydrocephalus in head trauma patients who underwent DC. The distance between DC and center line is correlated to the development of hydrocephalus.