摘要
目的探讨影响颅脑外伤术后脑水肿发生的危险因素。方法 回顾性分析2003年1月～2009年11月在本院神经外科手术治疗的137例急性硬膜外血肿患者的临床资料及术后脑水肿发生情况,统计分析影响颅脑外伤术后脑水肿发生的危险因素。结果通过单因素分析发现:术前GCS 3～8分、术前瞳孔散大、血肿量>100mL、手术时间拖延>12h和中线移位>9mm是危险因素;通过Logistic回归分析发现:术前GCS评分3～8分、术前瞳孔散大和手术时间拖延>12h是颅脑外伤术后脑水肿发生的独立危险因素。结论影响颅脑外伤术后脑水肿发生的主要独立危险因素是术前GCS评分、术前瞳孔大小和手术时间的早晚,早期手术是避免或减轻术后脑水肿的有效措施,临床应予以高度重视,对有上述危险因素的患者应及时行去骨瓣减压治疗以及后续的脱水治疗,以改善患者的预后。
Objective To investigate the risk factors responsible for brain edema after sugery of traumatic brain injury. Methods Take a retrospective analysis on the clinical data of 137 patients received treatment in our hospital from January 2003 to November 2009 and analyse the risk factors responsible for brain edema after sugery of traumatic brain injury. Results Univariate analysis found：Preoperative CCS scores 3 to 8,preoperative mydriasis,hematoma volume〉100mL,the operation time delay〉12h and midline shift〉9mm were the risk factors;while Logistic regression analysis showed that：Preoperative GCS scores 3 to 8,preoperative mydriasis and operation time delay〉12h were independent risk factors responsible for brain edema after sugery of traumatic brain injury. Conclusion Preoperative GCS scores,preoperative pupil size and early or late of operation time are the main independent risk factors responsible for brain edema after traumatic brain injury, early surgery is an effective measure to avoid or reduce postoperative brain edema and should be payed great attention,for patients with above risk factors, decompressive craniectomy in time and subsequent dehydration treatment should be taken to improve prognosis.
出处
《中国现代医生》
2011年第12期131-132,共2页
China Modern Doctor
