颅脑外伤患者标准大骨瓣减压术后脑膨出发生情况及其影响因素

Occurrence of Encephalocele After Standard Large Decompressive Craniectomy in Patients with Traumatic Brain Injury and Its Influencing Factors

目的分析颅脑外伤(TBI)患者标准大骨瓣减压术(LDC)术后脑膨出发生情况及其影响因素。方法回顾性分析76例行标准LDC治疗的TBI患者的临床资料,统计术后脑膨出发生情况,采用单因素和多因素分析探讨脑膨出发生的影响因素。结果76例TBI患者标准LDC术后发生脑膨出53例。单因素和Logistic回归分析显示,术前GCS评分<8分、未进行人工硬膜减张缝合、术后颅内感染及术后迟发性脑出血是TBI患者标准LDC术后发生脑膨出的危险因素(OR>1,P<0.05)。结论术前GCS评分<8分、未进行人工硬膜减张缝合、术后颅内感染及术后迟发性脑出血均可能导致TBI患者标准LDC术后发生脑膨出。

Objective To analyze the occurrence of encephalocele after standard large decompressive craniectomy(LDC)in patients with traumatic brain injury(TBI)and its influencing factors.Methods The clinical data of 76 TBI patients treated with standard LDC were retrospectively analyzed,and the incidence of postoperative encephalocele was counted.Univariate analysis and multivariate analysis were used to explore the influencing factors for the occurrence of encephalocele.Results Among 76 TBI patients,53 had encephalocele after standard LDC.Univariate analysis and Logistic regression analysis showed that preoperative GCS score<8 points,unperformed artificial dural decompression suture,postoperative intracranial infection and postoperative delayed intracerebral hemorrhage were the risk factors for the occurrence of encephalocele after standard LDC in TBI patients(OR>1,P<0.05).Conclusions Preoperative GCS score<8 points,unperformed artificial dural decompression suture,postoperative intracranial infection and postoperative delayed intracerebral hemorrhage may lead to encephalocele after standard LDC in TBI patients.