颅脑损伤患者去骨瓣减压术后发生脑积水的影响因素

Influencing factors of hydrocephalus after decompressive craniectomy in patients with craniocerebral injuries

目的:探讨颅脑损伤患者去骨瓣减压术后发生脑积水的影响因素。方法:选取105例颅脑损伤患者为研究对象,所有患者术后均获得3个月随访,统计颅脑损伤患者去骨瓣减压术后脑积水发生率,采用Logistic回归分析颅脑损伤患者去骨瓣减压术后发生脑积水的影响因素。结果:105例颅脑损伤患者去骨瓣减压术后发生脑积水40例,发生率为38.10%;发生脑积水患者的骨窗面积≥75 cm^(2)、术后昏迷时间≥14 d、蛛网膜下腔出血、形成脑疝占比均高于未发生脑积水患者,差异有统计学意义(P<0.05);经Logistic回归分析结果显示,骨窗面积≥75 cm^(2)、术后昏迷时间≥14 d、蛛网膜下腔出血、形成脑疝均为影响颅脑外伤患者去骨瓣减压术后发生脑积水的危险因素(OR>1,P<0.05)。结论:骨窗面积≥75 cm^(2)、术后昏迷时间≥14 d、蛛网膜下腔出血、形成脑疝均为影响颅脑外伤患者去骨瓣减压术后发生脑积水的危险因素。

Objective:To explore influencing factors of hydrocephalus after decompressive craniectomy in patients with craniocerebral injuries.Methods:105 patients with craniocerebral injuries were selected as the research objects,and all patients were followed up for 3 months after the surgery.The incidence of hydrocephalus after decompressive craniectomy in these patients with craniocerebral injuries was analyzed.Logistic regression was used to analyze the influencing factors of hydrocephalus after decompressive craniectomy in the patients with craniocerebral injuries.Results:Among the 105 patients with craniocerebral injuries,hydrocephalus occurred in 40 cases with an incidence rate of 38.10%.The bone window area(≥75 cm^(2)),the postoperative coma time(≥14 d),the subarachnoid hemorrhage,and the incidence of brain herniation in the patients with hydrocephalus were higher than those without hydrocephalus,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that bone window area≥75 cm^(2),postoperative coma time≥14 d,subarachnoid hemorrhage,and formation of brain herniation were the risk factors for hydrocephalus after decompressive craniectomy in the patients with craniocerebral injuries(OR>1,P<0.05).Conclusions:Bone window area≥75 cm^(2),postoperative coma time≥14 d,subarachnoid hemorrhage,and formation of brain herniation are the risk factors for hydrocephalus after decompressive craniectomy in the patients with craniocerebral injuries.