颅脑损伤患者术后发生硬膜外血肿的影响因素

Influencing factors of postoperative epidural hematoma in patients with craniocerebral injuries

目的:分析颅脑损伤患者术后发生硬膜外血肿的影响因素。方法:回顾性分析2018年4月至2021年4月该院收治的30例颅内血肿清除术后发生硬膜外血肿的颅脑损伤患者的临床资料,纳入发生组;另收集同期该院收治的30例颅内血肿清除术后未发生硬膜外血肿的颅脑损伤患者的临床资料,纳入未发生组。比较两组基线资料,分析颅脑损伤患者术后发生硬膜外血肿的影响因素。结果:发生组去除骨瓣、颅骨骨折、术前低血压占比均高于未发生组,差异有统计学意义(P<0.05);两组性别、年龄、受伤类型、受伤机制、开放性损伤、基底池受压、入院时格拉斯哥昏迷指数(GCS)评分、手术时间、受伤着力部位占比比较,差异均无统计学意义(P>0.05);经Logistics回归分析结果显示,去除骨瓣、颅骨骨折、术前低血压均为颅脑损伤患者术后发生硬膜外血肿的危险因素(OR>1,P<0.05)。结论:去除骨瓣、颅骨骨折、术前低血压均为颅脑损伤患者术后发生硬膜外血肿的危险因素,临床可据此制订针对性措施。

Objective:To analyze influencing factors of postoperative epidural hematoma in patients with craniocerebral injuries.Methods:The clinical data of 30 patients with craniocerebral injuries who developed epidural hematoma after removal of intracranial hematoma from April 2018 to April 2021 were retrospectively analyzed and included in occurrence group.The clinical data of 30 patients with craniocerebral injuries who did not develop epidural hematoma after removal of intracranial hematoma were included in non-occurrence group.The baseline data of the two groups were compared.The influencing factors of postoperative epidural hematoma in the patients with craniocerebral injuries were analyzed.Results:The proportions of bone flap removal,skull fracture and preoperative hypotension in the occurrence group were higher than those in the nonoccurrence group,and the differences were statistically significant(P<0.05).There were no significant differences in gender,age,injury type,injury mechanism,open injury,basal cistern compression,Glasgow coma scale(GCS)score on admission,operation time,and injury focus between the two groups(P>0.05).Logistic regression analysis showed that bone flap removal,skull fracture and preoperative hypotension were the risk factors for postoperative epidural hematoma in the patients with craniocerebral injuries(OR>1,P<0.05).Conclusions:Bone flap removal,skull fracture and preoperative hypotension are the risk factors for postoperative epidural hematoma in the patients with craniocerebral injuries.