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重度创伤性脑损伤患者创伤后脑积水的影响因素

Influencing factors for posttraumatic hydrocephalus in patients suffering from severe traumatic brain injuries.

作者信息

Jiao Qing-fang, Liu Zhan, Li Song, Zhou Liang-xue, Li San-zhong, Tian Wei, You Chao

机构信息

Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu 610041, China.

出版信息

Chin J Traumatol. 2007 Jun;10(3):159-62.

Abstract

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 equal to 1.050, 95%CI: 1.012-1.090), decompressive craniectomy (OR equal to 4.312, 95%CI: 1.127-16.503), subarachnoid hemorrhage(OR equal to 43.421, 95%CI: 7.835-240.652) and continuous lumbar drainage of cerebrospinal fluid (OR equal to 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, decompressive craniectomy and subarachnoid hemorrhage (SAH). Continuous lumbar drainage of cerebrospinal fluid can greatly reduce posttraumatic hydrocephalus.

摘要

目的

探讨重型颅脑损伤患者创伤后脑积水的影响因素,为临床治疗提供理论参考。

方法

回顾性分析我院139例重型颅脑损伤患者的临床资料。将患者分为脑积水组和非脑积水组。采用单因素分析和多因素分析确定与脑积水相关的因素。多因素分析采用logistic回归。

结果

19.42%的患者发生创伤后脑积水。从9个因素中筛选出年龄(OR=1.050,95%CI:1.012-1.090)、去骨瓣减压术(OR=4.312,95%CI:1.127-16.503)、蛛网膜下腔出血(OR=43.421,95%CI:7.835-240.652)及脑脊液持续腰大池引流(OR=0.045,95%CI:0.011-0.175)为创伤后脑积水的影响因素。

结论

创伤后脑积水的危险因素包括年龄、去骨瓣减压术和蛛网膜下腔出血。脑脊液持续腰大池引流可显著降低创伤后脑积水的发生率。

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