创伤性颅脑损伤去骨瓣减压术后并发症的危险因素分析

目的 探讨创伤性颅脑损伤去骨瓣减压术后并发症的发生情况及危险因素,提高临床预后及疗效.方法 回顾性分析298例创伤性颅脑损伤后去骨瓣减压患者的临床资料,分析去骨瓣减压术后并发症的危险因素.结果 298例患者中男193例,女105例,年龄(38.23±10.86)岁,最常见的致伤因素是交通事故(162/298,54.36％).76例(25.50％)出现去骨瓣减压术并发症,最常见的是硬膜下积液(32/298,10.74％).单因素分析结果表明:年龄、入院GCS评分、手术时机、血肿位置、血肿量与并发症的发生密切相关;Logistic回归分析结果提示入院GCS评分、血肿量为危险因素.结论 创伤性颅脑损伤去骨瓣减压术后并发症较常见,早期手术干预(＜12 h)有利于减少并发症的发生,颅脑损伤较重、脑内大量血肿的患者更易出现并发症.

Complications secondary to decompressive craniectomy in traumatic brain injury: an analysis of risk factors

Objective To discuss the incidence, influencing factors and management of various complications following cranioplasty. MethodsThe clinical data of 298 traumatic brain injury patients, who received surgical decompression, were retrospectively analyzed, and the risk factors of surgical complications following surgical decompression were analyzed. Results The patients included 193 males and 105 females, with a mean age of (38.23±10.86) years. Traffic accident (162/298, 54.36%) was the most common cause of the injuries, and surgical complications were found in 76 (25.50%) cases. Single factor analysis showed that age, admission GCS score, timing of surgery, hematoma location and hematoma volume were significantly associated with surgical complications. Logistic regression indicated that admission GCS score and hematoma volume were independent factors of surgical complications. Conclusion Complications are frequently seen in traumatic brain injury patients following decompressive craniectomy; patients with severe traumatic brain injury and great intracerebral hematoma are more likely to have complications. Early surgical intervention (<12 h) can help to reduce the complications.