摘要
目的研究去骨瓣减压术治疗颅脑损伤后血肿增大的风险因素。方法回顾性分析2022年1月至2023年8月本院收治的颅脑损伤117例,所有患者均行去骨瓣减压术,根据术后CT检查血肿是否增大分为发生组(n=62)与未发生组(n=55)。比较两组一般资料及鹿特丹CT评分(Rotterdam CT)、格拉斯哥昏迷评分(GCS)间的差异,经多因素Logistic回归分析去骨瓣减压术治疗颅脑损伤后血肿增大的危险因素。结果两组患者性别、合并高血压、高脂血症、冠心病比较差异无统计学意义(P>0.05),发生组年龄≥65岁、瞳孔散大、发病至开颅时间<4h占比及RotterdamCT评分、血糖、骨瓣最大径明显高于非血肿增大组,GCS评分低于未发生组,差异有统计学意义(P<0.05);多因素Logistic回归分析结果显示,年龄、Rotterdam CT评分、GCS评分、瞳孔状态、发病至开颅时间、血糖、骨瓣最大径是颅脑损伤患者术后血肿增大的危险因素(P<0.05)。结论颅脑损伤患者术后血肿增大受诸多因素影响,其中年龄、瞳孔状态、GCS评分、Rotterdam CT评分、发病至开颅时间、血糖、骨瓣最大径可预测患者术后血肿情况,应予以密切关注。
Objective To study the risk factors of hematoma enlargement after traumatic brain injury treated with decompressive craniectomy.Methods Retrospective analysis of clinical data of 117 cases of traumatic brain injury admitted to our hospital from January 2022 to August 2023.All patients underwent decompressive craniectomy and were divided into an occurring group(n=62)and a non occurring group(n=55)based on postoperative CT examination to determine whether the hematoma had increased.Compare the general data of two groups[gender,age,comorbidities(hypertension,h yperlipidemia,coronary heart disease),pupil status,time from onset to craniotomy,blood sugar,maximum diameter of bone flap],as well as the differences between Rotterdam Computed Tomography Score(Rotterdam CT)and Glasgow Coma Scale(GCS).Analyzed the risk factors for increased hematoma after craniocerebral injury treated with decompressive craniectomy using multivariate Logistic regression.Results There was no statistically significant difference in gender,concomitant hypertension,hyperlipidemia,and coronary heart disease between the two groups of patients(P>0.05).The proportion of patients with age≥65 years old,dilated pupils,time from onset to craniotomy<4 hours,as well as the Rotterdam CT score,blood sugar,and maximum diameter of bone flap in the incidence group were significantly higher than those in the non hematoma enlargement group.The GCS score was lower than that in the non incidence group,and the difference was statistically significant(P<0.05).The results of multivariate logistic regression analysis showed that age,Rotterdam CT score,GCS score,pupil status,time from onset to craniotomy,blood sugar,and maximum diameter of bone flap were risk factors for postoperative hematoma enlargement in patients with traumatic brain injury,all of which were P<0.05.Conclusion Postoperative hematoma enlargement in patients with traumatic brain injury is influenced by various factors,including age,pupil status,GCS score,Rotterdam CT score,time from onset to craniotomy,blood glucose,and maximum diameter of bone flap,which can predict the postoperative hematoma situation of the disease and should be closely monitored clinically.
出处
《浙江临床医学》
2024年第5期703-705,共3页
Zhejiang Clinical Medical Journal
关键词
去骨瓣减压术
颅脑损伤
血肿增大
瞳孔状态
骨瓣最大径
Decompression surgery with bone flap removal
Craniocerebral injury
Hematoma enlargement Pupil status
Maximum diameter of bone flap
