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中华神经创伤外科电子杂志 ›› 2016, Vol. 02 ›› Issue (04) : 215 -219. doi: 10.3877/cma.j.issn.2095-9141.2016.04.006

所属专题: 文献

临床研究

外伤后急性弥漫性脑肿胀术中急性脑膨出相关危险因素分析
孙瑾1, 张俊卿1, 黄延林1, 田新华1,()   
  1. 1. 361002 厦门,厦门大学附属中山医院神经外科
  • 收稿日期:2016-03-21 出版日期:2016-08-15
  • 通信作者: 田新华
  • 基金资助:
    2014年厦门市科技局基金项目(3502Z20144016); 2015年福建省青年基金项目(2015-2-50)

Risk factors for acute encephalocele during operation in patients with post-traumatic acute diffuse brain swelling

Jin Sun1, Junqing Zhang1, Yanlin Huang1, Xinhua Tian1,()   

  1. 1. Department Neurosurgery of Zhongshan Hospital Affiliated to Xiamen University, Ximen 361004, China
  • Received:2016-03-21 Published:2016-08-15
  • Corresponding author: Xinhua Tian
  • About author:
    Correspongding author: Tian Xinhua, Email:
引用本文:

孙瑾, 张俊卿, 黄延林, 田新华. 外伤后急性弥漫性脑肿胀术中急性脑膨出相关危险因素分析[J/OL]. 中华神经创伤外科电子杂志, 2016, 02(04): 215-219.

Jin Sun, Junqing Zhang, Yanlin Huang, Xinhua Tian. Risk factors for acute encephalocele during operation in patients with post-traumatic acute diffuse brain swelling[J/OL]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2016, 02(04): 215-219.

目的

探讨外伤后急性弥漫性脑肿胀PADBS术中急性脑膨出相关危险因素。

方法

对厦门大学附属中山医院神经外科自2010年1月至2015年12月收治的58例PADBS开颅减压术中发生急性脑膨出(病例组)与47例同期术中未发生脑膨出(对照组)患者的性别,年龄,受伤至手术时间,减速性颅脑损伤,合并多发伤,颅脑CT血肿厚度,脑疝,术前GCS评分,术中低血压,手术方式进行病例对照研究,通过Logistic多因素回归分析术中急性脑膨出相关危险因素。

结果

Logistic多因素回归分析显示减速性颅脑损伤,术前GCS评分,脑疝,术中低血压与PADBS术中急性脑膨出发生密切相关。

结论

减速性颅脑损伤,术前GCS评分,脑疝,术中低血压是PADBS发生术中急性脑膨出的独立危险因素,术前准确评估伤情及术中积极控制可降低PADBS术中急性脑膨出发生风险。

Objective

To explore the risk factors of acute encephalocele during operation in patients with PADBS(post-traumatic acute diffuse brain swelling).

Methods

Gender, age, time from injured to operation,deceleration craniocerebral injury, multiple injuries,cranial CT scan hematoma thickness,hernia, GCS scale before operation, hypotension during operation, operation methods were recorded and analyzed the risk factors in 58 acute encephalocele during operation in patients with PADBS(study group)and 47 patients without acute encephalocele (control group)by multi-factor regression analysis.

Results

Deceleration craniocerebral injury, hernia, GCS scale before operation, hypotension during operation were closely correlated with the occurrence of acute encephalocele during operation.

Conclusions

Deceleration craniocerebral injury, hernia, GCS scale before operation, hypotension during operation are the risk factors for acute encephalocele during operation. Precise evaluation before operation and active control during operation will reduce the risk of acute encephalocele during operation in patients with PADBS.

图1 外伤后急性弥漫性脑肿胀伤后及术中脑膨出颅脑患者的CT影像学检查
表1 外伤后急性弥漫性脑肿胀开颅手术中急性脑膨出10个危险因素及赋值
表2 外伤后急性弥漫性脑肿胀开颅手术中急性脑膨出Logistic回归分析结果
[1]
Yoshino E,Yamaki T,Higuchi T, et al. Acute brain edema in fatal head injury: analysis by dynamic CT scanning[J]. J Neurosurg, 1985, 63(6): 830-839.
[2]
Soustiel JF,Sviri GE,Mahamid E, et al. Cerebral blood flow and metabolism following decompressive craniectomy for control of increased intracranial pressure[J]. Neurosurgery, 2010, 67(1): 65-72.
[3]
Losiniecki A,Shutter L. Management of traumatic brain injury[J]. Curr Treat Options Neurol, 2010, 12(2): 142-154.
[4]
Marshall LF,Marshall SB,Klaube MR, et al. The diagnosis of head injury requires a classification based on computed axial tomography[J]. J Neurotrauma, 1992, 9 Suppl 1: S287-S292.
[5]
Csokay A,Emelifeonwu JA,Fugedi L, et al. The importance of very early decompressive craniectomy as a prevention to avoid the sudden increase of intracranial pressure in children with severe traumatic brain swelling (retrospective case series)[J]. Childs Nerv Syst, 2012, 28(3): 441-444.
[6]
Sahuquillo J,Poca MA,Amoros S. Current aspects of pathophysiology and cell dysfunction after severe head injury[J]. Curr Pharm Des, 2001, 7(15): 1475-1503.
[7]
Balestreri M,Czosnyka M,Hutchinson P, et al. Impact of intracranial pressure and cerebral perfusion pressure on severe disability and mortality after head injury[J]. Neurocrit Care, 2006, 4(1): 8-13.
[8]
Daboussi A,Minville V,Leclerc-Foucras S, et al. Cerebral hemodynamic changes in severe head injury patients undergoing decompressive craniectomy[J]. J Neurosurg Anesthesiol, 2009, 21(4): 339-345.
[9]
Xu FH,Chen WJ,Yang YJ, et al. Evaluation of multislice computed tomographic perfusion imaging and computed tomographic angiography on traumatic cerebral infarction[J]. Chin J Traumatol, 2008, 11(3): 186-189.
[10]
何黎民,卢亦成,吴建国,等.额、枕部直接冲击导致中脑损伤的力学机制研究[J].中华神经外科杂志, 2007, 23(07): 493-495.
[11]
Beeker DP,Gade GF,Young HF. Intracranial heamatoma. In:Youmam JR eds. Neurological Surgery[M]. Philadephia: Saunders,1990, 2079-2080.
[12]
Li LM,Timofeev I,Czosnyka M, et al.Review article: the surgical approach to the management of increased intracranial pressure after traumatic brain injury[J]. Anesth Analg, 2010, 111(3): 736-748.
[13]
Salluh JI,Martins GA,Santino MS, et al. Early use of terlipressin in catecholamine-resistant shock improves cerebral perfusion pressure in severe traumatic brain injury[J]. Acta Anaesthesiol Scand, 2007, 51(4): 505-508.
[14]
江基尧,朱诚,罗其中,主编.颅脑创伤临床救治指南[M].第3版,上海第二军医大学出版社, 2007: 129-136.
[15]
Graham DI,McIntosh TK,Maxwell WL, et al. Recent advances in neurotrauma[J]. J Neuropathol Exp Neurol, 2000, 59(8): 641-651.
[16]
Bao YH,Liang YM,Gao GY, et al. Bilateral decompressive craniectomy for patients with malignant diffuse brain swelling after severe traumatic brain injury: a 37-case study[J]. J Neurotrauma, 2010, 27(2): 341-347.
[17]
Zheng W,Wei Q,Qin J, et al. CT finding is an index in assessment of outcome in patients with diffuse traumatic brain swelling[J]. Chin J Traumatol, 2000, 3(1): 23-25.
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