摘要
目的探讨颅脑损伤开颅术后硬膜下积液形成的影响因素,并针对影响因素制定对策。方法回顾性分析2015年2月—2020年2月在本院实施开颅术的200例患者临床资料,按照术后有无硬膜下积液分为A组(硬膜下积液,n=60)和B组(无硬膜下积液,n=140)两组,分析影响开颅术后硬膜下积液形成的影响因素,并制定预防措施。结果A组年龄、性别、手术时机、血肿位置与B组比较,差异无统计学意义(P>0.05);A组术前格拉斯哥昏迷指数(GCS)评分3~5分、中线结构位移≥10 mm、血肿量>40 ml、合并脑室内出血、合并脑皮层出血、合并脑积水、合并蛛网膜下腔出血占比高于B组,差异有统计学意义(P<0.05);经Logistic回归分析发现,术前GCS评分3~5分、中线结构位移≥10 mm、血肿量>40 ml、合并脑室内出血、合并脑皮层出血、合并脑积水、合并蛛网膜下腔出血是开颅术后硬膜下积液的危险因素(P<0.05)。结论开颅术后硬膜下积液受多种因素影响,应划分具有高危因素的患者,优化手术方案,实施有效护理,以减轻预后风险。
Objective To investigate the influencing factors of subdural effusion after craniotomy for craniocerebral injury,and to develop countermeasures based on the influencing factors.Methods The clinical data of 200 patients underwent craniotomy in the hospital from February 2015 to February 2020 were retrospectively analyzed.They were divided into A group(with subdural effusion,n=60)and B group(without subdural effusion,n=140)according to the presence or absence of subdural effusion after surgery.The influencing factors of subdural effusion after craniotomy were analyzed,and the preventive measures were developed.Results There was no statistical difference in the age,gender,operation opportunity,hematoma location between A group and B group(P>0.05).The proportion of preoperative Glasgow Coma Scale(GCS)within 3-5 points,midline structural displacementequal or more than10 mm,volume of hematoma over 40 mL,intraventricular hemorrhage,cerebral cortex hemorrhage,hydrocephalus,subarachnoid hemorrhage in A group was higher than that in B group,and the difference was statistically significant(P<0.05).Logistic regression analysis showed that preoperative GCS within 3-5 points,midline structural displacement equal or more than10 mm,volume of hematoma over 40 mL,intraventricular hemorrhage,cerebral cortex hemorrhage,hydrocephalus,subarachnoid hemorrhage were risk factors of subdural effusion after craniotomy(P<0.05).Conclusions Subdural effusion after craniotomy is affected by many factors.It is necessary to divide the patients with high-risk factors,optimize the surgical procedures and implement effective nursing to reduce the prognostic risk.
作者
李宝嘉
林春英
莫泉
梁才干
林子同
周秀传
LI Bao-jia(Department of neurosurgery,people's hospital of Huaiji county,Zhaoqing,Guangdong,526400,China)
出处
《齐齐哈尔医学院学报》
2020年第14期1732-1734,共3页
Journal of Qiqihar Medical University
基金
广东省肇庆市科技创新指导项目(2016040307)。
