脑外伤后脑积水发生的风险因素分析

Risk Factors Related to Traumatic Hydrocephalus

目的探讨脑外伤后脑积水发生的风险因素。方法回顾性分析2001年1月至2012年1月因颅脑外伤在淄博市妇幼保健院接受治疗的760例患者的临床资料,根据是否发生脑积水分为脑积水组和非脑积水组,比较两组在性别、年龄、有无颅骨骨折、有无脑挫裂伤、有无合并脑室出血等11个相关指标上有无差异。结果脑积水组及非脑积水组患者在脑挫裂伤发生率、脑室出血发生率、硬膜下血肿发生率、外伤性蛛网膜下腔出血发生率、开颅手术率、昏迷发生率、脑脊液升高率等指标的差异均有统计学意义(P<0.05),颅骨骨折和硬膜外血肿等指标差异无统计学意义(P>0.05)。Logistic回归分析发现,脑室出血、硬膜下血肿、外伤性蛛网膜下腔出血、脑脊液压力升高是脑外伤后脑积水发生的风险因素。结论脑室出血、硬膜下血肿、外伤性蛛网膜下腔出血、脑脊液压力升高为脑外伤后发生脑积水的风险因素。

Objective To study the risk factors related to traumatic hydrocephalus.Methods Clinical data of 760 cerebral trauma patients who were treated at Zibo City Maternal and Child Health Hospital from Jan.2000 to Jan.2012 was retrospectively analyzed.They were divided into hydrocephalus group and non-hydrocephalus group.11 related indicators such as gender,age,skull fracture,with or without cerebral contusion,whether with merger intraventricular hemorrhage of the two groups were compared.Results The incidence of brain contusion,post-traumatic subarachnoid hemorrhage,subdural hematoma,ventricular hemorrhage,coma,ventnricle-cerebrosinal fluid pressure of the two groups had statistically significant difference（P 0.05）;while the differences in indicators of skull fracture and epidural hematoma were not statistically significant（P 0.05）.Logistic regression analysis found that cerebral ventricle hemorrhage,subdural hematoma,traumatic subarachnoid hemorrhage,cerebrospinal fluid pressure were risk factors for hydrocephalus after traumatic brain injury.Conclusion Intraventricular hemorrhage,subdural hematoma,traumatic subarachnoid hemorrhage,cerebrospinal fluid pressure are risk factors for hydrocephalus to occur after traumatic brain injury.