目的探讨颅骨修补术同期行脑室-腹腔或脑室-心房分流术对治疗颅脑外伤术后颅骨缺损合并脑积水患者的临床疗效,评价其临床可行性。方法选取我院2014年9月至2016年6月收治的64例颅脑外伤术后颅骨缺损合并脑积水患者,随机数字表法分为观察...目的探讨颅骨修补术同期行脑室-腹腔或脑室-心房分流术对治疗颅脑外伤术后颅骨缺损合并脑积水患者的临床疗效,评价其临床可行性。方法选取我院2014年9月至2016年6月收治的64例颅脑外伤术后颅骨缺损合并脑积水患者,随机数字表法分为观察组(n=32)和对照组(n=32):观察组术后3个月内颅骨缺损修补术同期行脑室-腹腔或脑室-心房分流术,对照组术后3个月内行脑室-腹腔或脑室-心房分流术,3个月后行颅骨缺损修补术。观察两组患者术后脑积水症状改善情况、随访3个月后预后情况、临床效果及术后并发症情况。结果脑积水症状改善观察组与对照组比较无统计学意义(χ~2=0.005,P>0.05);2组患者术后3个月格拉斯哥昏迷评分(Glasgow coma scale,GCS)、格拉斯哥预后评分(Glasgow outcome score,GOS)、神经功能缺损评分优于治疗前(P<0.05),且术后情况观察组明显优于对照组,差异有统计学意义(P<0.05);随访3个月后观察组的良好率(59.38%)明显高于对照组(31.25%),差异有统计学意义(χ~2=7.23,P<0.05)。术后并发症发生率观察组6.25%(2/32)明显低于对照组31.25%(10/32),差异有统计学意义(χ~2=7.13,P<0.05)。结论颅脑外伤术后颅骨缺损合并脑积水患者颅骨修补术同期行分流术术后并发症发生率低,临床预后好,疗效确定,值得临床推广应用。展开更多
Objective: To detect the influencing factors for posttraumatic hydrocephalus in patients with severe traumatic brain injuries and provide theoretical reference for clinical treatment. Methods : Retrospective study ...Objective: To detect the influencing factors for posttraumatic hydrocephalus in patients with severe traumatic brain injuries and provide theoretical reference for clinical treatment. Methods : Retrospective study was made on 139 patients with severe traumatic brain injuries in our hospital. The patients were divided into two groups: hydrocephalus group and non-hydrocephalus group. Single factor analysis and multiple factor analysis were used to determine the related factors and hydrocephalus. Multiple factor analysis was conducted with logistic regression. Results: Posttraumatic hydrocephalus was found in 19.42% of patients. Age ( OR=1.050, 95% CI: 1.012-1. 090 ), decompressive craniectomy ( OR =4.312, 95 %CI : 1. 127-16.503 ), subarachnoid hemorrhage ( OR = 43.421, 95 % CI : 7. 835-240. 652 ) and continuous lumbar drainage of cerebrospinal fluid ( OR =0.045, 95%CI: 0. 011-0. 175) were screened out from nine factors as the influencing factors for posttraumatic hydrocephalus. Conclusions : Risk factors for PTH are as follows: age, deeompressive eranieetomy and subaraehnoid hemorrhage (SAH). Continuous lumbar drainage of eerebrospinal fluid can greatly reduce posttraumatic hydrocephalus.展开更多
文摘目的探讨颅骨修补术同期行脑室-腹腔或脑室-心房分流术对治疗颅脑外伤术后颅骨缺损合并脑积水患者的临床疗效,评价其临床可行性。方法选取我院2014年9月至2016年6月收治的64例颅脑外伤术后颅骨缺损合并脑积水患者,随机数字表法分为观察组(n=32)和对照组(n=32):观察组术后3个月内颅骨缺损修补术同期行脑室-腹腔或脑室-心房分流术,对照组术后3个月内行脑室-腹腔或脑室-心房分流术,3个月后行颅骨缺损修补术。观察两组患者术后脑积水症状改善情况、随访3个月后预后情况、临床效果及术后并发症情况。结果脑积水症状改善观察组与对照组比较无统计学意义(χ~2=0.005,P>0.05);2组患者术后3个月格拉斯哥昏迷评分(Glasgow coma scale,GCS)、格拉斯哥预后评分(Glasgow outcome score,GOS)、神经功能缺损评分优于治疗前(P<0.05),且术后情况观察组明显优于对照组,差异有统计学意义(P<0.05);随访3个月后观察组的良好率(59.38%)明显高于对照组(31.25%),差异有统计学意义(χ~2=7.23,P<0.05)。术后并发症发生率观察组6.25%(2/32)明显低于对照组31.25%(10/32),差异有统计学意义(χ~2=7.13,P<0.05)。结论颅脑外伤术后颅骨缺损合并脑积水患者颅骨修补术同期行分流术术后并发症发生率低,临床预后好,疗效确定,值得临床推广应用。
文摘Objective: To detect the influencing factors for posttraumatic hydrocephalus in patients with severe traumatic brain injuries and provide theoretical reference for clinical treatment. Methods : Retrospective study was made on 139 patients with severe traumatic brain injuries in our hospital. The patients were divided into two groups: hydrocephalus group and non-hydrocephalus group. Single factor analysis and multiple factor analysis were used to determine the related factors and hydrocephalus. Multiple factor analysis was conducted with logistic regression. Results: Posttraumatic hydrocephalus was found in 19.42% of patients. Age ( OR=1.050, 95% CI: 1.012-1. 090 ), decompressive craniectomy ( OR =4.312, 95 %CI : 1. 127-16.503 ), subarachnoid hemorrhage ( OR = 43.421, 95 % CI : 7. 835-240. 652 ) and continuous lumbar drainage of cerebrospinal fluid ( OR =0.045, 95%CI: 0. 011-0. 175) were screened out from nine factors as the influencing factors for posttraumatic hydrocephalus. Conclusions : Risk factors for PTH are as follows: age, deeompressive eranieetomy and subaraehnoid hemorrhage (SAH). Continuous lumbar drainage of eerebrospinal fluid can greatly reduce posttraumatic hydrocephalus.