摘要
目的分析颅脑外伤患者去骨瓣减压术(DC)骨瓣大小与术后并发症的关系。方法回顾性分析颅脑外伤行DC治疗108例患者的临床资料。按骨瓣面积分为小骨瓣组(46例)、中骨瓣组(53例)和大骨瓣组(9例),比较组间相关指标的差异,分析骨瓣大小与术后并发症之间的关系。结果单因素分析显示,三组脑膨出、硬脑膜下积液发生率和伤后6个月GOS评分均有统计学差异(P<0.05)。骨瓣越大,脑膨出和硬脑膜下积液的发生率越高,伤后6个月GOS评分越低,预后越差。三组其他并发症,如颅内出血、脑梗死、脑脊液切口漏、颅内感染、反常性脑疝、脑积水、颅骨缺损综合征和癫痫等发生率均无统计学差异(P>0.05)。结论在颅脑外伤行DC患者中,骨窗大小是脑膨出和硬脑膜下积液的影响因素。在满足病情需要的前提下,应尽可能减小骨窗,改善预后。
Objective To analyze the relationship between bone flap size and postoperative complications in craniocerebral trauma patients underwent decompressive craniectomy(DC).Methods Clinical data of 108 craniocerebral trauma patients underwent DC were retrospectively analyzed.According to the size of bone flap,the patients were assigned into small bone flap group(46 cases),middle bone flap group(53 cases)and large bone flap group(9 cases).The differences in the relevant indicators among three groups were compared and the relationship between bone flap size and postoperative complications was analyzed.Results Univariate analysis showed that the differences in the incidence of encephalocele and subdural accumulation of fluid and the GOS score of 6 months after operation were significant among three groups(P<0.05).The larger the area of the bone flap,the higher the incidence of encephalocele and subdural accumulation of fluid,the less GOS score of 6 months after operation and the poorer prognosis.There were no significant differences in the other complications such as intracranial hemorrhage,cerebral infarction,cerebrospinal fluid leakage,intracranial infection,paradoxical herniation,hydrocephalus and skull defect syndrome among three groups(P>0.05).Conclusion In craniocerebral trauma patients underwent DC,the bone flap size is a influencing factor for encephalocele,subdural accumulation of fluid and therefor bone flap area should be kept as small as possible for reducing the complications and improving the prognosis.
作者
罗雨
王存祖
张恒柱
陈品
施学强
于波
易盼
EUO Yu;WANG Cunzu;ZHANG Hengzhu(Dalian Medical University,Dalian 116027,CHINA)
出处
《江苏医药》
CAS
2018年第11期1260-1263,共4页
Jiangsu Medical Journal
关键词
颅脑外伤
去骨瓣减压术
颅骨瓣
术后并发症
Craniocerebral trauma
Decompressive craniectomy
Bone flap
Postoperative complications
