早期颅骨修补术与创伤性脑损伤去骨瓣减压术后创伤后脑积水发生率降低有关。
Early cranioplasty associated with a lower rate of post-traumatic hydrocephalus after decompressive craniectomy for traumatic brain injury.
机构信息
Department of Neurosurgery, School of Medicine, Bahcesehir University, Istanbul, Turkey.
School of Medicine, Department of Neurosurgery, Erzincan Binali Yildirim University, Erzincan, Turkey.
出版信息
Eur J Trauma Emerg Surg. 2020 Aug;46(4):919-926. doi: 10.1007/s00068-020-01409-x. Epub 2020 Jun 3.
BACKGROUND
Post-traumatic hydrocephalus (PTH) is one of the primary complications during the course of traumatic brain injury (TBI). The aim of this study was to define factors associated with the development of PTH in patients who underwent unilateral decompressive craniectomy (DC) for TBI.
METHODS
A total of 126 patients, who met the inclusion criteria of the study, were divided into two groups: patients with PTH (n = 25) and patients without PTH (n = 101). Their demographic, clinical, radiological, operative, and postoperative factors, which may be associated with the development of PTH, were compared.
RESULTS
Multivariate logistic regression analysis revealed that cranioplasty performed later than 2 months following DC was significantly associated with the requirement for ventriculoperitoneal shunting due to PTH (p < 0.001). Also, a significant unfavorable outcome rate was observed in patients with PTH at 1-year follow-up according to the Glasgow Outcome Scale-Extended (p = 0.047).
CONCLUSIONS
Our results show that early cranioplasty within 2 months after DC was associated with a lower rate of PTH development after TBI.
背景
创伤性脑损伤（TBI）过程中，创伤后脑积水（PTH）是主要并发症之一。本研究旨在明确行单侧去骨瓣减压术（DC）治疗 TBI 患者发生 PTH 的相关因素。
方法
共纳入符合研究标准的 126 例患者，将其分为 PTH 组（n=25）和非 PTH 组（n=101）。比较两组患者的人口统计学、临床、影像学、手术及术后等可能与 PTH 发生相关的因素。
结果
多因素 logistic 回归分析显示，DC 后 2 个月以上行颅骨修补术与 PTH 患者行脑室-腹腔分流术的需求显著相关（p<0.001）。根据格拉斯哥预后扩展量表（GOS-E），PTH 患者在 1 年随访时的不良预后率显著更高（p=0.047）。
结论
我们的研究结果表明，DC 后 2 个月内早期行颅骨修补术与 TBI 后 PTH 发生率降低有关。
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