神经外科康复单元脑外伤后脑积水发生危险因素分析

doi:10.3969/j.issn.1006-9771.2020.09.015

Abstract

Abstract:

Objective To investigate the risk factors related to hydrocephalus following traumatic brain injury in neurosurgical rehabilitation unit.
Methods From January 1st, 2016 to December 31st, 2017, 176 patients with traumatic brain injury admitting to the Department of Neurosurgery of Beijing Bo'ai Hospital were selected. They were divided into hydrocephalus group and non-hydrocephalus group according to the admitting diagnosis, and analyzed the related factors with univariate analysis and Logistic multiple regression.
Results There were 46% patients with hydrocephalus. Traumatic subarachnoid hemorrhage (OR = 4.127, 95%CI 1.742~9.776), course of disease (OR = 3.377, 95%CI 2.281~5.000) and process of operation (OR = 2.265, 95%CI 1.076~4.770) were independent risk factors to hydrocephalus.
Conclusion Hydrocephalus often emerge after traumatic brain injury in the rehabilitation period, especially for those with subarachnoid hemorrhage, course of disease over two months and surgery within 24 hours after injury.

Key words: traumatic brain injury, hydrocephalus, rehabilitation unit, risk factors

HU An-ming,WANG Yu,SUN Wei. Risk Factors Related to Hydrocephalus Following Traumatic Brain Injury in Neurosurgical Rehabilitation Unit[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(9): 1083-1088.

Figures/Tables 2

References 30

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相关因素	非脑积水组(n = 95)	脑积水组(n = 81)	χ²值	P值
性别			0.026	0.871
男	76	64
女	19	17
年龄(岁)			2.540	0.468
≤ 18	17	12
19~44	34	24
45~60	30	35
>60	14	10
地区			0.308	0.579
北京市	19	19
非北京市	76	62
致伤原因			–^a	0.475
交通事故	61	56
坠落伤	7	7
砸伤	11	4
摔伤	15	13
刀割伤	1	0
原因不明	0	1
并发其他系统损伤			0.739	0.390
无	69	54
有	26	27
创伤性蛛网膜下腔出血			3.331	0.068
无	47	29
有	48	52
受伤后手术时间(h)			16.354	0.001
未手术	38	11
< 24	49	60
24~48	6	5
> 48	2	5
伤后意识状态			2.957	0.228
清醒	13	9
意识模糊	3	0
昏迷	79	72
伤后病程			–^a	< 0.001
1~4周	39	7
4 < ~8周	35	16
8 < ~12周	9	19
12周< ~12个月	12	37
> 12个月	0	2
入院时意识状态			0.177	0.915
清醒	54	45
微意识状态	7	5
昏迷	34	31
脑损伤类型			–^a	0.039
弥漫性轴索损伤	5	1
脑挫裂伤	11	2
脑内血肿	6	3
硬膜外血肿	4	6
硬膜下血肿	6	10
脑干损伤	3	0
多种类型合并损伤	60	59
颅骨缺损			3.576	0.059
无	40	23
有	55	58
行气管切开			11.475	< 0.001
无	51	23
有	44	58
并发颅内感染			2.454	0.117
无	92	74
有	3	7

自变量	β	SE	Wald	P值	OR	95%CI
创伤性蛛网膜下腔出血	1.418	0.440	10.380	0.001	4.127	1.742~9.776
病程	1.217	0.200	36.926	< 0.001	3.377	2.281~5.000
受伤后手术时间	0.818	0.380	4.631	0.031	2.265	1.076~4.770
脑损伤类型	-0.509	0.441	1.331	0.249	0.601	0.253~1.427
颅骨缺损	0.630	0.535	1.386	0.239	1.877	0.658~5.353
行气管切开	0.617	0.400	2.376	0.123	1.852	0.846~4.057

Risk Factors Related to Hydrocephalus Following Traumatic Brain Injury in Neurosurgical Rehabilitation Unit

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