重型颅脑损伤术中急性脑膨出相关高危因素分析

Analysis of High-risk Factors Related to Acute Encephalocele during Surgery for Severe Traumatic Brain Injury

目的:探讨重型颅脑损伤术中发生急性脑膨出的相关危险因素。方法:采用便利抽样法收集修文县人民医院2016年1月-2021年12月收治的109例重型颅脑损伤病例资料作为研究对象,其中21例术中发生急性脑膨出纳入研究组,88例术中未发生急性脑膨出纳入对照组。统计两组一般资料的差异性,将差异有统计学意义(P<0.05)的因素作为自变量,采用多因素Logistic回归分析术中发生急性脑膨出的相关危险因素。结果:研究组受伤至手术时间≥6 h、合并重要器官组织损伤、术前GCS评分3~5分、术前Rotterdam CT评分3~5比例高于对照组,差异有统计学意义(P<0.001),通过多因素Logistic回归分析,发现受伤至手术时间、合并重要器官组织损伤、术前GCS评分、术前Rotterdam CT评分均是影响重型颅脑损伤术中发生急性脑膨出的重要高危因素,OR值均>1。结论:对于受伤至手术时间≥6 h、合并重要器官组织损伤、术前GCS评分3~5分、术前Rotterdam CT评分3~5分的重型颅脑损伤患者应在术前及术中采取相应的控制措施,以降低重型颅脑损伤患者术中发生急性脑膨出的风险。

Objective:To investigate the risk factors of acute encephalocele during severe traumatic brain injury surgery.Method:The data of 109 cases of severe craniocerebral injury treated in Xiuwen County People’s Hospital from January 2016 to December 2021 were collected by the convenience sampling method as the research objects.Among them,21 cases of intraoperative acute encephalocele were included in the study group,and 88 cases of without acute encephalocele were included in the control group.The differences in general data between the two groups were counted,and the factors with significant differences(P<0.05)were used as independent variables,and multivariate Logistic regression was used to analyze the risk factors for acute encephalocele during surgery.Result:In the study group,the time from injury to operation≥6 hours,combined with major organ tissue injury,preoperative GCS score of 3-5,and preoperative Rotterdam CT score of 3-5 were higher than those in the control group,and the differences were statistically significant(P<0.001).Multivariate Logistic regression showed time from injury to operation,combined with vital organ tissue damage,preoperative GCS scores and preoperative Rotterdam CT scores were important high-risk factors for acute encephalocele during severe traumatic brain injury,and the OR values were all>1.Conclusion:For patients with severe craniocerebral injury with time from injury to operation≥6 hours,combined with vital organ tissue damage,preoperative GCS score of 3-5 points,and preoperative Rotterdam CT score of 3-5 points,corresponding control measures should be taken before and during operation to reduce the risk of intraoperative acute encephalocele in patients with severe traumatic brain injury.