颅脑损伤术后患者的精神障碍发生现状

The current statue of mental disorders in patients with craniocerebral injury after surgery

目的调查颅脑损伤术后精神障碍发生现状及其危险因素。方法纳入广西玉林市第一人民医院神经外科2017年4月~2021年6月80例颅脑损伤患者,符合手术适应症,受伤后48h内接受手术。术后评估精神障碍发生情况,并以是否发生精神障碍分组,调查并比较两组患者年龄、合并症等病历资料,采用logistic回归分析调查精神障碍危险因素。结果80例颅脑损伤患者术后检出精神障碍27例,占比33.75%,精神障碍组与无精神障碍组额叶损伤、手术方法、年龄、颅内血肿、合并低氧血症、入院格拉斯哥昏迷评分(Glasgow coma scale,GCS)、受伤至入院时间差异具有统计学意义(P<0.05),两组性别、学历、受伤原因差异无统计学意义(P>0.05);logistic回归分析显示,额叶损伤、入院GCS评分≤8分、颅内血肿、合并低氧血症、开颅手术是颅脑损伤术后精神障碍的危险因素。结论颅脑损伤术后精神障碍发生率较高,额叶损伤、入院昏迷程度高、颅内血肿等会增加精神障碍发生风险。

Objective To investigate the current situation and risk factors of postoperative mental disorders after craniocerebral injury surgery.Methods From April 2017 to June 2021,80 patients with craniocerebral injury were included in the neurosurgery department of the First People's Hospital of Yulin City,Guangxi.Patients who meet the surgical indications and undergo surgery within 48 hours after injury.Postoperative of the occurrence of mental disorders were evaluated.Group based on whether mental disorders have occurred.The medical records such as age and comorbidities between two groups of patients were investigated and compared.The logistic regression analysis were used to investigate risk factors for mental disorders.Results 27 out of 80 patients with traumatic brain injury were found to have mental disorders after surgery,accounting for 33.75%.There was a statistically significant difference in frontal lobe injury,surgical method,age,intracranial hematoma,combined hypoxemia,Glasgow coma scale(GCS)on admission,and time from injury to admission between the mental disorder group and the non mental disorder group(P<0.05).There was no statistically significant difference in gender,education level,and cause of injury between the two groups(P>0.05).Logistic regression analysis showed that frontal lobe injury,admission GCS score≤8 points,intracranial hematoma,combined hypoxemia,and craniotomy were risk factors for postoperative mental disorders after craniocerebral injury.Conclusion The incidence of mental disorders after craniocerebral injury surgery is relatively high,and frontal lobe injury,high degree of coma upon admission,and intracranial hematoma can increase the risk of mental disorders.