本文選題：重型顱腦損傷　切入點：去骨板減壓　出處：《寧夏醫(yī)科大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的探究自體顱骨修補術后并發(fā)癥及其相關危險因素的分析。資料與方法回顧性分析2011年1月至2014年11月按相關標準納入132例寧夏醫(yī)科大學總醫(yī)院神經外科的需行自體顱骨修補的患者,分析患者性別、年齡、手術時間、顱骨缺損面積、手術間隔時間與術后并發(fā)癥的關系,先進行單因素統計分析,將差異有統計學意義的因素再進行Logistic多因素回歸分析,篩選出術后并發(fā)癥的獨立危險因素。結果1、自體顱骨修補術后并發(fā)癥發(fā)生率為14.39%(19/132),其中術后出現頭皮下積液3例,切口感染3例,骨質吸收發(fā)生1例,硬膜外積液發(fā)生2例,硬膜下積液發(fā)生4例,術后繼發(fā)性癲癇發(fā)生最多為6例,發(fā)生率為4.55%(6/132)。2、經單因素分析發(fā)現術后并發(fā)癥的危險因素為:年齡(P=0.002)、顱骨缺損面積(P=0.001)。經Logistic多因素回歸分析顯示,年齡(P=0.031)、顱骨缺損面積(P=0.001)是影響術后并發(fā)癥發(fā)生的獨立危險因素。3、性別對術后并發(fā)癥的發(fā)生差異無統計學意義(P=0.152),手術時間對術后并發(fā)癥的發(fā)生差異無統計學意義(P=0.332),手術間隔時間對術后并發(fā)癥的發(fā)生差異無統計學意義(P=0.384)。結論本研究中,顱骨修補術后并發(fā)癥發(fā)生率較高,達到14.4%(19/132),包括繼發(fā)性癲癇,硬膜下積液,切口感染,頭皮下積液,硬膜外積液,骨質吸收等。其中術后繼發(fā)性癲癇發(fā)生率最高,達到4.5%�；颊叩哪挲g和顱骨缺損面積是影響自體顱骨修補術后并發(fā)癥發(fā)生的獨立危險因素。
[Abstract]:Objective to investigate the complications and related risk factors after autogenous cranioplasty. Data and methods retrospective analysis of 132 cases of neurosurgery in Ningxia Medical University General Hospital from January 2011 to November 2014. Patients undergoing autogenous skull repair, Sex, age, operative time, area of skull defect, operative interval and postoperative complications were analyzed. Univariate statistical analysis was performed, and then Logistic multivariate regression analysis was carried out. Results 1 the incidence of complications after autologous cranioplasty was 14.39 / 132%, including 3 cases of subscalp effusion, 3 cases of incision infection, 1 case of bone resorption, 2 cases of epidural effusion, 1 case of postoperative complications, 1 case of bone resorption, 2 cases of epidural effusion, 1 case of incision infection, 1 case of bone resorption and 2 cases of epidural effusion. There were 4 cases of subdural effusion and 6 cases of secondary epilepsy after operation. The incidence rate was 4.55 / 13 / 2. By univariate analysis, the risk factors of postoperative complications were as follows: age (P < 0.002), cranial defect area (P < 0.001), and Logistic multivariate regression analysis. Age and skull defect area were independent risk factors for postoperative complications. There was no significant difference between sex and postoperative complications (P = 0.152), but there was no significant difference in operative time and postoperative complications (P = 0.332P = 0.332P = 0.332P = 0.332P = 0.332P = 0.332P = 0.332P < 0.01). There was no significant difference between the interval time and postoperative complications. Conclusion in this study, there is no significant difference in the incidence of postoperative complications. The incidence of complications after cranioplasty was relatively high, reaching 14.4% of 132um, including secondary epilepsy, subdural effusion, incisional infection, subscalp effusion, epidural effusion, bone resorption and so on. The incidence of post-operative secondary epilepsy was the highest. The age of the patient and the area of skull defect were independent risk factors for complications after autogenous cranioplasty.
【學位授予單位】：寧夏醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R651.1

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