重型及特重型颅脑损伤患者继发性脑积水发生的影响因素分析

Abstract
Figure/Table
References (23)
Related Citation (15)

Download: PDF (0 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To analyze the factors affecting the occurrence of secondary hydrocephalus in patients with severe and very severe craniocerebral injury.Methods A total of 63 patients with severe and very severe craniocerebral injury admitted to Changshu Second People′s Hospital from January 2015 to February 2020 were selected,and the patients were divided into severe group (34 cases) and very severe group (29 cases) according to the severity of the injury.The clinical data of the patients and the condition of secondary hydrocephalus were recorded,and the multivariate regression analysis was used to analyze the influencing factors of secondary hydrocephalus in patients with severe and very severe craniocerebral injury.Results There were no significant differences in gender,age and cause of injury between the two groups (P＞0.05).There were 19 cases (30.16%) with secondary hydrocephalus,6 cases (17.65%) with secondary hydrocephalus in the severe group and 13 cases (44.83%) with secondary hydrocephalus in the very severe group.Univariate analysis results showed that age,degree of injury,Glasgow coma scale (GCS) score,decompressive craniectomy treatment,location of hematoma,intracranial infection and intracerebral hematoma were the influencing factors for secondary hydrocephalus in patients with severe and very severe craniocerebral injury (P＜0.05).Multivariate analysis showed that age (β=0.841,OR=2.854,95%CI:2.741-4.901),GCS score (β=2.687,OR=6.541,95%CI:3.957-7.537),location of hematoma (β=0.677,OR=1.147,95%CI:1.014-3.284) and intraventricular hemorrhage (β=1.035,OR=2.254,95%CI:1.954-5.257) were independent influencing factor for the occurrence of secondary hydrocephalus in patients with severe and very severe craniocerebral injury (P＜0.05).Conclusion Severe and very severe craniocerebral injury patients with old age,low GCS score,subdural and intracerebral hematoma,intraventricular hemorrhage are prone to secondary hydrocephalus,and reasonable measures should be taken to intervene risk factors to reduce the incidence of secondary hydrocephalus.

Key words： Severe head injury Very severe head injury Secondary hydrocephalus Risk factors

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	ZHANG Xu-ming
	SUN Cheng-fa
	CHU Rong-tao

Cite this article:

ZHANG Xu-ming,SUN Cheng-fa,CHU Rong-tao. Analysis of factors affecting the occurrence of secondary hydrocephalus in patients with severe and very severe craniocerebral injury[J]. 中国当代医药, 2020, 27(35): 90-93.

URL:

https://www.dangdaiyiyao.com/EN/ OR https://www.dangdaiyiyao.com/EN/Y2020/V27/I35/90

[1]	郝亚华，梁英，李小彦.高压氧治疗颅脑损伤致昏迷患者的疗效观察[J].中国药物与临床，2017，17（2）：242-243.
[2]	刘佳骐，徐勇，林爱明.重型颅脑损伤合并脑疝39例诊治分析[J].实用临床医药杂志，2017，21（21）：205.
[3]	刘海兵，魏梁锋，洪景芳，等.创伤性重型颅脑损伤早期格拉斯哥昏迷量表评分动态变化与CTP 的相关性[J].临床神经外科杂志，2018，15（6）：448-451.
[4]	陈刚，陈吉才，张强.颅脑损伤致精神障碍的流行病学和损伤特征分析[J].中国伤残医学，2013，（5）：387-388.
[5]	潘伟明，程彦，乔智灏.重型颅脑损伤合并胸腹部损伤患者预后影响因素分析[J].中国现代药物应用，2020，14（10）：4-6.
[6]	代金龙，李继波，杜向阳，等.重度脑外伤患者去骨瓣减压后发生脑积水的危险因素分析[J].立体定向和功能性神经外科杂志，2019，32（4）：227-231.
[7]	丁锦荣，管义祥，吴德模，等.重型颅脑损伤并发脑积水的相关因素分析[J].中国综合临床，2016，32（6）：552-554.
[8]	罗小程.重症颅脑损伤患者术后NIHSS评分的影响因素分析[J].临床与病理杂志，2016，36（8）：1108-1112.
[9]	Kavelin R，Vijay L，Bharadwaj J，et al.Hydrocephalus in Pediatric Traumatic Brain Injury：National Incidence，Risk Factors，and Outcomes in 124 444 Patients[J].Pediatr Neurol，2018，80：70-76.
[10]	章成，曹灵红.儿童颅脑继发性损伤预后的影响因素分析[J].西部医学，2015，27（12）：1816-1818.
[11]	张雄新，李玉雄.闭合性颅脑损伤患者并发进展性出血性损伤危险因素分析[J].解放军医药杂志，2017，29（12）：49-52.
[12]	卫正洪，岳林，万晓强，等.重度颅脑损伤患者术后并发脑积水的相关因素分析[J].立体定向和功能性神经外科杂志，2016，29（5）：302-305.
[13]	张超，易勇，周世军，等.联合天幕裂孔切开术较单纯标准大骨瓣减压术治疗重型颅脑损伤疗效的Meta分析[J].中国微侵袭神经外科杂志，2016，21（6）：248-253.
[14]	邓继成.重度颅脑损伤行大骨瓣减压术后并发脑积水危险因素分析[J].中国医学创新，2011，8（34）：144-145.
[15]	陶治鹤，胡伟，毛进鹏.重型和特重型颅脑损伤病人术后继发性脑积水的危险因素分析[J].中西医结合心脑血管病杂志，2020，18（8）：1315-1319.
[16]	Kaen A，Jimenez-Roldan L，Alday R，et al.Interhemispheric hygroma after decompressive craniectomy：does it predict posttraumatic hydrocephalus?[J].J Neurosurg，2010，113（6）：1287-1293.
[17]	张建民.颅骨缺损合并脑积水及脑软化灶形成的手术治疗（附40例报告）[J].中国临床神经外科杂志，2016，21（1）：51-52.
[18]	王宝，郝丽，刘晓东.控制性减压术治疗中老年人重型颅脑损伤的临床研究[J].中国基层医药，2019，26（10）：1157-1160.
[19]	任骥，蒋正方，吴贵强，等.颅脑损伤患者脑积水分流术后感染病原菌与耐药性监测[J].中华医院感染学杂志，2016，26（9）：2018-2020.
[20]	马继伟，闫东明，朱旭强，等.神经内镜下第三脑室底造瘘术治疗慢性创伤性脑积水[J].中华创伤杂志，2016，32（2）：110-114.
[21]	曹轲，刘玉飞，钱振，等.重型和特重型颅脑损伤患者术后继发性脑积水的影响因素分析[J].中华神经外科杂志，2016，32（6）：584-588.
[22]	中华神经外科分会神经创伤专业组，中华创伤学会分会神经创伤专业组.颅脑创伤后脑积水诊治中国专家共识[J].中华神经外科杂志，2014，30（8）：840-843.
[23]	陈浪，严正村，佘磊，等.脑室-腹腔分流术联合颅骨成形术治疗颅脑损伤去骨板减压术后脑积水[J].中国临床神经外科杂志，2017，22（8）：593-594.