重症外伤性脑损伤患者去骨瓣减压术后并发外伤性脑梗死的影响因素

Influencing Factors of Post-Traumatic Cerebral Infarction in Patients with Severe Traumatic Brain Injury After Decompressive Craniectomy

目的探讨重症外伤性脑损伤患者去骨瓣减压术(DC)后并发外伤性脑梗死(PTCI)的影响因素。方法选取2018年7月至2021年7月商丘市第四人民医院收治的接受手术治疗的40例重症外伤性脑损伤DC后并发PTCI纳入发生组,另选取同期接受手术的40例重症外伤性脑损伤DC后未发生PTCI患者纳入未发生组;记录两组患者基线资料,分析重症外伤性脑损伤患者DC术后并发PTCI的影响因素。结果发生组蛛网膜下腔出血、术中低血压、脑疝、弥散性血管内凝血(DIC)评分≥5分患者占比高于未发生组(P<0.05);logistic回归分析结果显示,蛛网膜下腔出血、术中低血压、脑疝、DIC评分≥5分是重症外伤性脑损伤患者DC术后并发PTCI的影响因素(OR>1,P<0.05)。结论蛛网膜下腔出血、术中低血压、脑疝、DIC评分≥5分是重症外伤性脑损伤患者DC术后并发PTCI的影响因素。

Objective To investigate the influencing factors of post-traumatic cerebral infarction(PTCI)after decompressive craniectomy(DC)in patients with severe traumatic brain injury.Methods A total of 40 patients with severe traumatic brain injury who had PTCI after DC and completed surgical treatment in Shangqiu Fourth People’s Hospital from July 2018 to July 2021 were collected and included in the occurrence group.In addition,there were 40 patients with severe traumatic brain injury who did not have PTCI after DC were selected during the same period,and they were included in the non-occurring group.The baseline data of patients in the two groups were recorded,and the influencing factors of PTCI after DC in patients with severe traumatic brain injury were analyzed.Results The proportion of patients with subarachnoid hemorrhage,intraoperative hypotension,cerebral hernia and disseminated intravascular coagulation(DIC)score≥5 in the occurrence group was higher than that in the non-occurrence group(P<0.05).Through logistic regression analysis,the results showed that subarachnoid hemorrhage,intraoperative hypotension,cerebral hernia and DIC score≥5 were the influencing factors of PTCI after DC in patients with severe traumatic brain injury(OR>1,P<0.05).Conclusion Subarachnoid hemorrhage,intraoperative hypotension,cerebral hernia and DIC score≥5 are the influencing factors of PTCI after DC in patients with severe traumatic brain injury.