创伤性颅脑损伤去骨瓣减压144例术后并发症分析

Postoperative complications of decompressive craniectomy for traumatic brain injury: 144 case

目的分析创伤性颅脑损伤去骨瓣减压术后并发症的发生情况及危险因素。方法将144例创伤性颅脑损伤患者经确诊后行去骨瓣减压术治疗,分析患者术后并发症发生情况及危险因素。结果创伤性颅脑损伤去骨瓣减压术后并发症发生率为51.39%。而脑膨出、脑积水、硬膜下积液为发生率最高的3种并发症。患者年龄、格拉斯哥昏迷评分(GCS评分)、血肿量、血肿部位、骨瓣大小和手术时机均是影响患者术后并发症的危险因素,差异有统计学意义(P<0.05)。结论创伤性颅脑损伤患者去骨瓣减压术后并发症发生率较高,临床可针对可控因素给予积极预防和处理,以期改善患者预后。

Objective To explore the incidence and risk factors of postoperative complications for decompressive craniectomy for trau-matic brain injury.Methods Totally 144 patients diagnosed as traumatic brain injury underwent decompressive craniectomy,and post-operative complications as well as risk factors were analyzed.Results Postoperative complication rate of traumatic brain injury after de-compressive craniectomy was 51.39%.And encephalocele,hydrocephalus,and subdural effusion were the three complications with the highest incidence.Age,GCS,hematoma volume,hematoma,bone size and timing of surgery were the risk factors of postoperative compli-cations.The differences were statistically significant（P 〈0.05）.Conclusions There was a higher incidence of postoperative complica-tions among patients with traumatic brain injury.Positive interventions can be performed on the controllable factors to improve prognosis.