环池形态改变与颅脑损伤开颅术后常见并发症的关系研究
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摘要
目的探讨环池形态与颅脑损伤开颅术后常见并发症的关系。方法选取我院2013年11月～2016年11月行去骨瓣减压术279例,探讨环池形态改变与颅脑损伤开颅术后常见并发症的关系。结果环池受压变窄136例,术后未出现并发症38例,出现一种并发症58例,两种31例,三种及以上9例,其中胃出血38例,肺部感染24例,高血糖21例,泌尿系感染16例,腹泻20例,迟发性颅内血肿14例,其他15例;环池单侧闭塞84例,出现一种并发症30例,两种42例,三种及以上12例,其中胃出血49例,肺部感染38例,高血糖25例,泌尿系感染8例,腹泻13例,迟发性颅内血肿9例,其他11例。环池双侧全闭59例,出现一种并发症6例,两种18例,三种及以上35例,其中胃出血53例,肺部感染51例,高血糖33例,泌尿系感染2例,腹泻2例,迟发性颅内血肿6例,其他10例。结论环池形态改变越严重,术后并发症种类越多。胃出血,肺部感染和高血糖的发生率与环池受压程度呈正相关,腹泻发生率与环池受压程度呈负相关,迟发性颅内血肿和泌尿系统感染与环池受压程度无关。
Objective To explore the relationship between ambient cistern and common complications in patients with craniocerebral trauma. Methods 279 cases of decompressive craniectomy in our hospital from November 2013 to November 2016 were selected to explore the relationship between ambient cistern and common complications in patients with craniocerebral trauma. Results 136 cases with narrow ambient cistern,38 cases had no postoperative complications,58 cases had a kind of complications,31 cases had two kinds of complications,9 cases had three kinds of complications. 38 cases of gastrorrhagia,24 cases of pulmonary infection,21 cases of hyperglycaemia,16 cases of urinary tract infection,20 cases of diarrhea,14 cases of delayed intracranial hematoma,15 cases of the others. There were 84 cases of unilateral ambient cistern occlusion. There were 30 case of one kind of complications,42 case of two kinds of complications,12 case of three or more kinds of complications,including 49 cases of gastrorrhagia,38 cases of pulmonary infection,25 cases of hyperglycaemia,8 cases of urinary tract infection,13 cases of diarrhea,9 cases of delayed intracranial hematoma and 11 cases of the others. There were 59 cases of both sides of blocked ambient cistern. There were 6 case of one kind of complications,18 case of two kinds of complications,35 case of three or more kinds of complications,including 53 cases of gastrorrhagia,51 cases of pulmonary infection,33 cases of hyperglycaemia,2 cases of urinary tract infection,2 cases of diarrhea,6 cases of delayed intracranial hematoma and 10 cases of the others. Conclusion The more serious the change of the ambient cistern,the more kinds of postoperative complications. The incidence of gastrorrhagia,pulmonary infection and hyperglycaemia was positively associated with the degree of compression,the incidence of diarrhea was negatively correlated to the degree of compression,delayed intracranial hematoma and urinary tract infection was not associated with the degree of compression.
Objective To explore the relationship between ambient cistern and common complications in patients with craniocerebral trauma. Methods 279 cases of decompressive craniectomy in our hospital from November 2013 to November 2016 were selected to explore the relationship between ambient cistern and common complications in patients with craniocerebral trauma. Results 136 cases with narrow ambient cistern,38 cases had no postoperative complications,58 cases had a kind of complications,31 cases had two kinds of complications,9 cases had three kinds of complications. 38 cases of gastrorrhagia,24 cases of pulmonary infection,21 cases of hyperglycaemia,16 cases of urinary tract infection,20 cases of diarrhea,14 cases of delayed intracranial hematoma,15 cases of the others. There were 84 cases of unilateral ambient cistern occlusion. There were 30 case of one kind of complications,42 case of two kinds of complications,12 case of three or more kinds of complications,including 49 cases of gastrorrhagia,38 cases of pulmonary infection,25 cases of hyperglycaemia,8 cases of urinary tract infection,13 cases of diarrhea,9 cases of delayed intracranial hematoma and 11 cases of the others. There were 59 cases of both sides of blocked ambient cistern. There were 6 case of one kind of complications,18 case of two kinds of complications,35 case of three or more kinds of complications,including 53 cases of gastrorrhagia,51 cases of pulmonary infection,33 cases of hyperglycaemia,2 cases of urinary tract infection,2 cases of diarrhea,6 cases of delayed intracranial hematoma and 10 cases of the others. Conclusion The more serious the change of the ambient cistern,the more kinds of postoperative complications. The incidence of gastrorrhagia,pulmonary infection and hyperglycaemia was positively associated with the degree of compression,the incidence of diarrhea was negatively correlated to the degree of compression,delayed intracranial hematoma and urinary tract infection was not associated with the degree of compression.
引文
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[2]吴浩. CT环池变化与颅脑损伤的预后研究[J].中国现代医药杂志,2013,15(2):110-113.
[3]杨国芳.颅脑损伤CT环池动态改变的原因及临床意义[J].中国急救复苏与灾害医学杂志,2013,8(1):80-82.
[4]张勇. CT环池改变对急性颅脑损伤的临床意义[J].当代医学,2016,22(32):27-28.
[5]王方勇. CT环池改变与颅脑损伤患者预后关系的研究[J].浙江创伤外科,2015,20(5):876-878.
[6]张永年,梁照平,张福成.环池变化在双额脑挫裂伤治疗中的临床意义分析[J].中国药物与临床,2015,15(2):256-257.
[7]兰青.颅底外科微创技术的应用[J].临床外科杂志,2017,25(9):646-649.
[8]雷霆,李龄.加强多学科合作,不断提高颅底神经外科诊治水平[J].临床外科杂志,2017,25(9):645.
[9]姜曙,周培志,尹森林.复杂颅底手术中的团队协作和多方式联合[J].临床外科杂志,2017,25(9):652-654.
[10]王红权,黄书岚.标准大骨瓣开颅手术对重型创伤性颅脑损伤所致颅内血肿的临床疗效研究[J].临床外科杂志,2015,23(6):420-422.