颅脑损伤去骨瓣减压术后交通性脑积水发生情况及影响因素分析

打开文本图片集

【中图分类号】 R651 【文献标志码】 B 【文章编号】 1672-7770（2025）06-0678-04

Abstract：Objective To analyze the occurrence and influencing factors of communicating hydrocephalus after decompresive craniectomy fortraumatic brain injury.MethodsA total of156 cases with traumatic brain injury from March 2015 to March 2O23 were selected as the study objects，allof whom underwent decompressive craniectomy. Theincidence of postoperative communicating hydrocephalus wasanalyzed for6 months after surgery，and the clinical dataof the patients were collected.The influencing factors ofcommunicating hydrocephalusaftercraniocerebral injury were analyzedbymultivariateLogisticregresion.ResultsAtotal of156cases with traumaticbrain injurywere included in this study，of which 48 patients（ 30.77% ） had communicating hydrocephalus 3 months after surgery，and 108 patients（ 69.24% ）had no communicating hydrocephalus.There were statistically significant diferences in injury type，preoperative GCS score，intracranial infection，postoperative lumbar puncture，bone window area，and dura mater sealing between the occurrence group and the non-occurrence group（ P<0 .05）．Multivariate Logistic regression analysis showed that preoperative Glasgow coma scale（GCS） score ⩽6 points（ OR=2.282 ，95% CI= 1.674-3.110），intracranial infection（ CI=1.696-2.631 ），no postoperative lumbar puncture （ OR=3.622 ，95% CI=1 .730-7.583），bone window area⩾160.82 cm²（ OR=3.034 ， 95% CI=1 .834- 5.021），and no dura mater suture（ OR=2.787 ，95 % CI=1.681-4.621 ）were risk factors forpostoperative communicating hydrocephalus in patients with craniocerebral injury（ P<0.05 ）.ConclusionsThe occurrence of communicating hydrocephalusafter decompressivecraniectomy in patients with traumatic brain injuryisrelated to factors such aslowpreoperativeGCS score，intracranial infection，nolumbarpunctureafter surgery，largebone flap area，andnodural suture.Early identificationand interventionof theaboverisk factorscanreduce theincidenceof communicating hydrocephalus and improve the prognosis of patients.

Key words：traumatic brain injury；communicating hydrocephalus；decompressve craniectomy；influencing factor； follow-up

颅脑损伤（traumaticbraininjury，TBI）是中国外科常见的创伤性疾病，现代社会交通正不断发展，但人民的安全意识相对薄弱，导致近年来 TBI发生率直线上升[1-2]。（剩余7366字）