颅脑创伤去骨瓣减压术后脑积水相关因素探讨

目的:探讨颅脑创伤患者行去骨瓣减压术后发生脑积水的相关因素。方法:对2004年1月至2010年12月我院69例行去骨瓣减压术颅脑创伤患者随访1年并分为脑积水组和无脑积水组,比较两组患者年龄、性别、术前Glasgow昏迷指数(GCS)评分、受伤到去骨瓣减压时间间隔、中线移位距离、去骨瓣减压方式及预后。结果:16例患者出现脑积水(23.2%),脑积水组患者双侧去骨瓣减压比率明显高于无脑积水组患者,其余观察指标两组间无明显差异。结论:双侧去骨瓣减压术可能是颅脑创伤患者发生脑积水的危险因素。

Investigation of the Factors Related to the Hydrocephalus Development after Decompressive Craniectomy in Traumatic Brain Injury

Objective To investigate the factors related to the hydrocephalus development after decompressive craniectomy in patients with traumatic brain injury. Methods 69 patients with traumatic brain injury and suffered with decompressive craniectomy in our hospital from January 2004 to December 2010 were selected and classified into two groups, hydrocephalus group and non- hydrocephalus group. The related factors, including age, sex, preoperative Glasgow coma scale（GCS）, interval between trauma and operation, midline shift in CT scan, type of decompressive craniectomy and outcome were assessed between these two groups. Results 16 patients（23.2 %） developed hydrocephalus. The proportion of bilateral craniectomy in hydrocephalus group was significant higher than the non- hydrocephalus group, while there was no significant difference in other data between these two groups. Conclusion The results suggest that the bilateral craniectomy may play an important role in the hydrocephalus development in patients with traumatic brain injury.