重型颅脑损伤患者大骨瓣减压术后颅内出血相关因素的分析.docVIP

重型颅脑损伤患者大骨瓣减压术后颅内出血相关因素的分析 　　【摘要】 目的：探讨重型颅脑损伤患者大骨瓣减压术后并发颅内出血的相关因素，为改善大骨瓣减压术的预后提供依据。方法：对25例术后并发颅内出血的临床病例与同期手术未发生颅内出血的68例病例的年龄、合并疾病、伤情、凝血功能、手术技术、术后血压等因素进行调查和对照分析，并进行统计学处理。结果：年龄、伤情、凝血功能、手术技术、术后血压等因素与并发颅内出血具有相关性（P0.05）。结论：年龄、 伤情、凝血功能、手术技术、术后血压是术后并发颅内出血的常见危险因素。 　　【关键词】 重型颅脑损伤； 大骨瓣手术； 颅内出血； 相关因素 　　Analysis of Related Factors for Intercranial Hemorrhage after Decompressive Craniectomy of Patients with Severe Traumatic Brain Injury/GONG Yuan- mei，NIE Ming-zhen.// Medical Innovation of China，2013，10（15）：143-145 　　【Abstract】 Objective：To exptore related factors for intercranial hemorrhage（IH） after decompressive craniectomy（DC） of patients with severe traumatic brain injury （sTBI） so that to improve prognosis of these patients provided clinic basis.Method：To survey and contrast analysis the factors of age，complication diseases，traumatic conditions，coagulation function，surgical technique and postoperative blood pressure in 25 patients with concurrent IH in postoperative and age，complication diseases，traumatic conditions，coagulation function，surgical technique and postoperative blood pressure in 68 patients with no concurrent IH in postoperative at the same period and then deal with statistics. Result：The factors of age，complication function，surgical technique and postoperative blood pressure were significantly correlated with postoperative IH （P0.05）.Conclusion：Age，complication diseases，traumatic conditions，coagulation function，surgical technique and postoperative blood pressure are common risk factors with postoperative concurrent. 　　【Key words】 Severe traumatic brain injury； Intercranial hemorrhage； Decompressive craniectomy； Related factors 　　First-author’s address：The People’s Hospital of Hanshou， Hanshou 415900，China 　　doi：10.3969/j.issn.1674-4985.2013.15.074 　　重型颅脑损伤（severe traumatic brain injury，sTBI）患者死亡率平均为30%～40%，其中约80%的患者死于伤后一周以内，死亡的主要原因是伤后各种原因所导致的难治性高颅压[1]。大骨瓣开颅减压术（decompressive craniectomy， DC）可预防性用于伤后颅内占位性血肿清除术，或者用于经最大限度的药物等措施保守治疗无效的弥漫性脑肿胀和顽固性高颅压患者，故D