摘要
目的探讨颅骨缺损修补术后癫痫发生的影响因素。方法采用回顾性病例对照研究分析2012年1月-2015年12月收治的171例颅骨缺损行颅骨修补术后患者临床资料，其中男126例，女45例；年龄16—78岁，平均50．9岁。根据是否发生癫痫将患者分为癫痫发作组（61例）和非癫痫发作组（110例）。记录两组性别、年龄、颅骨缺损原因、颅骨缺损部位、颅骨缺损时间、围术期抗癫痫药物使用、颅骨缺损区域凹陷体积（Vd）、颅骨缺损区域完整体积（Vf）、颅骨缺损区域凹陷率（Pd）等，采用单因素分析和多因素Logistic回归分析确定颅骨修补术后癫痫发作的独立危险因素。结果患者均获随访18—90个月，平均54个月。颅骨修补术后发生癫痫共61例，发生率为35．7％。单因素分析结果显示，年龄、颅骨缺损原因、颅骨缺损部位、颅骨缺损时间、围术期抗癫痫药物使用和Vf与颅骨缺损修补术后癫痫的发生无关（P〉0．05），性别、Vd和Pd可能与颅骨缺损修补术后癫痫的发生相关（P〈0．05）。多因素Logistic回归分析结果显示，Pd（OR=0．024，95％CI0．001—0．502，P〈0．05）为颅骨缺损修补术后癫痫发作的独立危险因素。结论Pd为颅骨缺损修补术后癫痫发作的独立危险因素，颅骨缺损区域凹陷程度影响颅骨缺损修补术后癫痫的发生。
Objective To investigate the factors affecting the incidence of epilepsy after cranioplasty. Methods A retrospective case control study was conducted on the clinical data of 171 patients with skull defect who underwent cranioplasty between January 2012 and December 2015. There were 126 males and 45 females, with an average age of 50.9 years （ range, 16-78 years ）. The patients were divided into epileptic seizure group （61 cases） and non epileptic seizure group （110 cases）. The gender, age, defect cause, defect location, defect duration, perioperative antiepileptic drug use, skull defect regional depression volume （Vd）, skull defect regional integrity volume （Vf）, skull defect regional depression rate （Pd） of two groups were recorded. Univariate analysis and multivariate logistic regression analysis were used to identify the independent risk factor of epilepsy after cranioplasty. Results All patients were followed up for 54 months averagely （range, 18-90 months）. Sixty-one patients （35.7%） had epilepsy after cranioplasty. Univariate analysis suggested that age, defect cause, defect location, defect duration, perioperative antiepileptic drug use, and Vf were not associated with epilepsy after cranioplasty （all P 〉 0.05） ; while gender, Vd, and Pd was associated with epilepsy after cranioplasty （P 〈 0.05 ）. Multivariate logistic regression analysis demonstrated that Pd（ OR =0. 024, 95% CI 0. 001-0. 502, P 〈 0.05 ） was independent predictor of epilepsy after cranioplasty. Conclusion Pd is an independent risk factor for epilepsy after cranioplasty and depression degree could significantly affect its incidence.
作者
俞学斌
包庆泉
Yu Xuebin;Bao Qingquan(Department of Neurosurgery,Shaoxing People＇s Hospital,Shaoxing Hospital of Zhejiang University,Shaoxing 312000,China)
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2018年第8期717-720,共4页
Chinese Journal of Trauma
关键词
癫痫
颅脑损伤
颅骨修补
Epilepsy
Craniocerebral trauma
Cranioplasty
