颅脑创伤后硬脑膜下积液的危险因素分析

Risk factors of subdural effusion in patients with craniocerebral trauma

目的探讨颅脑创伤患者发生硬脑膜下积液的危险因素。方法回顾性分析盐城市第三人民医院神经外科2008年9月至2016年1月收治的1126例颅脑创伤患者的临床资料。对患者的年龄、性别、格拉斯哥昏迷量表(GCS)评分、颅脑创伤类型、去骨瓣减压、使用脱水药、脱水药使用的时间和硬脑膜严密修补进行单因素分析;对有统计学意义的指标进行多因素Logistic回归分析,确定颅脑创伤后发生硬脑膜下积液的危险因素。结果 49例患者(4.4%)并发硬脑膜下积液。单因素分析显示,年龄、GCS评分、去骨瓣减压、脱水药使用、脱水药使用时间与颅脑创伤并发硬脑膜下积液有关。多因素Logistic回归分析显示,年龄(OR值1.923,95%CI 1.436~4.215,P=0.037)、去骨瓣减压(OR值2.176,95%CI 1.557~6.049,P=0.010)、使用脱水药(OR值1.874,95%CI 1.209~6.572,P=0.041)为颅脑创伤并发硬脑膜下积液的危险因素。结论颅脑创伤并发硬脑膜下积液(TSE)可能与年龄、去骨瓣减压及使用脱水药相关。

Objective To investigate the risk factors of subdural effusion in patients with craniocerebral trauma.Methods The clinical data of 1126 patients with craniocerebral trauma from September 2008 to January 2016 were analyzed retrospectively. The relevant factors of age,gender,GCS score,injury type,decompressive craniectomy,dehydrated drug,therapeutic time of dehydrated drug and dura sutured tightly were analyzed to evaluate the risk factors of subdural effusion in craniocerebral trauma patients. Results 49 patients（ 4. 4%） complicated with subdural effusion. Univariate analysis showed that age,GCS score,decompressive craniectomy,dehydrated drug and therapeutic time of dehydrated drug were the risk factors of subdural effusion in craniocerebral trauma patients.Multivariate logistic regression analysis showed that age（ OR 1. 923,95% CI 1. 436-4. 215,P = 0. 037）,decompressive craniectomy（ OR 2. 176,95% CI 1. 557-6. 049,P = 0. 010） and dehydrated drug（ OR 1. 874,95%CI 1. 209-6. 572,P = 0. 041） were the risk factors of subdural effusion in craniocerebral trauma patients.Conclusion The traumatic subdural effusion（ TSE） may be associated with age,decompressive craniectomy and dehydrated drug.