Wang Liang, Fan Shuangbo, Zhao Zhenping, Xu Qian
Department of Neurosurgery, Ningbo City Zhenhai District People's Hospital, Ningbo, Zhejiang 315200, China.
Evid Based Complement Alternat Med. 2021 Oct 27;2021:1519904. doi: 10.1155/2021/1519904. eCollection 2021.
In recent years, the incidence of craniocerebral trauma has increased, making it one of the important causes of death and disability in neurosurgery patients. The decompressive craniectomy (DC) after severe craniocerebral injury has become the preferred treatment for patients with severe craniocerebral injury, but the incidence of postoperative hydrocephalus has become a difficult problem in clinical treatment. This study observed the changes of nerve growth factor (NGF), adrenocorticotropic hormone (ACTH), and arginine vasopressin (AVP) levels in the CSF after DC in patients with craniocerebral injury and analyzed the relationship between the three indicators and communicating hydrocephalus. The results showed that the levels of NGF, ACTH, and AVP in patients with cranial injury after DC were significantly higher than those in healthy subjects, and subdural effusion, traumatic subarachnoid hemorrhage (tSAH), and the levels of NGF, ACTH, and AVP in the CSF were independent risk factors for communicating hydrocephalus. Monitoring the levels of NGF, ACTH, and AVP is of great significance for clinicians to judge the occurrence of traffic hydrocephalus, evaluate the prognosis of patients with craniocerebral injury after DC, and guide clinical treatment.
近年来，颅脑创伤的发病率有所上升，成为神经外科患者死亡和致残的重要原因之一。重度颅脑损伤后行去骨瓣减压术（DC）已成为重度颅脑损伤患者的首选治疗方法，但术后脑积水的发生率已成为临床治疗中的难题。本研究观察了颅脑损伤患者DC术后脑脊液中神经生长因子（NGF）、促肾上腺皮质激素（ACTH）和精氨酸加压素（AVP）水平的变化，并分析了这三项指标与交通性脑积水的关系。结果显示，DC术后颅脑损伤患者的NGF、ACTH和AVP水平显著高于健康受试者，硬膜下积液、创伤性蛛网膜下腔出血（tSAH）以及脑脊液中NGF、ACTH和AVP水平是交通性脑积水的独立危险因素。监测NGF、ACTH和AVP水平对临床医生判断交通性脑积水的发生、评估DC术后颅脑损伤患者的预后以及指导临床治疗具有重要意义。
