颅脑损伤后慢性脑积水和脑室扩张的危险因素及治疗策略

摘要

Objective To investigate the risk factors and treatment strategy of patients with chronic hydrocephalus and ventriculomegaly after traumatic brain injury (TBI).Methods Two hundred and eighty-eight patients with TBI from January 2013 to December 2013 in our hospital were selected.There were 27 patients with chronic PTH and PTV and 54 patients with non-chronic PTH and PTV among the above patients.The risk factors and treatment strategy of two groups were analyzed and compared.Results The Glasgow Coma Scale ,traumaticsubarachnoid hemorrhage ,subdural effusion and decompressive crani-ectomy could promote the occurrence of chronic PTH and PTV ,and the GCS≤8 and decompressive craniectomy were inde-pendent risk factors of chronic PTH and PTV after TBI.Conclusion The GCS≤8 and decompressive craniectomy are inde-pendent risk factors of chronic PTH and PTV after TBI ,and V-P shunt is an important measure treating chronic PTH.%目的：探讨颅脑损伤（TBI）后引起慢性外伤性脑积水（PTH）或外伤后脑室扩张（PTV）的危险因素及治疗对策。方法选择2013-01-2013-12住院的符合入选标准的288例TBI病人，观察发生慢性PTH和PTV的27例患者，同时按1∶2随机抽取的非慢性PTH或PTV的TBI患者54例作为对照。对2组病人的危险因素及治疗对策进行对比。结果格拉斯哥昏迷评分（GCS）、外伤性蛛网膜下腔出血（tSAH）、硬膜下积液和去骨瓣减压等4项对慢性PTH和PTV的发生有明显影响；GCS≤8分和去骨瓣减压是发生慢性PTH或PTV的独立危险因素。结论 GCS≤8分和去骨瓣减压是TBI后引起慢性PT H或PT V的危险因素，V-P分流是治疗慢性PT H的主要措施。