首页|颅脑血管重建术后切口并发症的影响因素分析

颅脑血管重建术后切口并发症的影响因素分析

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目的 探讨颅脑血管重建术后切口并发症的危险因素。方法 回顾性纳入2018年1月至2022年12月徐州医科大学附属医院收治的因颅脑血管疾病接受血管重建术的患者,将患者分为有切口并发症组和无切口并发症组。记录患者人口统计学、颅脑血管重建术后切口并发症的临床资料,将可能的影响因素纳入二元logistic回归分析,分析可能导致颅脑血管重建术后发生切口并发症的影响因素。结果 共纳入117例行颅脑血管重建术的患者,有切口并发症组25例(21。4%),其中7例(28。0%)为脂肪液化,4例(16。0%)为切口裂开,7例(28。0%)为切口感染,7例(28。0%)为皮肤坏死;无切口并发症组92例(78。6%)。单因素分析显示:患者颅脑血管重建术后有切口并发症组性别、年龄、高血压、高脂血症、吸烟、饮酒、疾病类型、血管重建类型与无切口并发症组比较,差异无统计学意义(P>0。05)。有切口并发症组糖尿病及损失颞浅动脉额支比例高于无切口并发症组。有切口并发症组BMI、头皮厚度、手术时间均大于无切口并发症组,差异有统计学意义(P<0。05)。多因素分析显示:头皮厚度大(OR=1。484,95%CI:1。024~2。149,P=0。037)、BMI 高(OR=1。323,95%CI:1。042~1。680,P=0。021)、损失颞浅动脉额支(OR=3。582,95%CI:1。146~11。190,P=0。028)是发生切口并发症的主要危险因素(P<0。05)。结论 BMI高、头皮厚度大、损失颞浅动脉额支是颅脑血管重建术后发生头皮切口并发症的独立危险因素。
Analysis of Influencing factors of incision complications after craniocerebrovascular reconstruction
Objective To explore the risk factors of incision complications after cerebral revasculariza-tion.Methods The patients who underwent vascular reconstruction for craniocerebral vascular diseases in the Affiliated Hospital of Xuzhou Medical University who underwent revascularization for cerebrovascular disea-ses from January 2018 to December 2022 were retrospectively included,and the patients were divided into the incision complications group and the no incision complications group.Among them,this study documented the delayed complications following incision healing after cerebral revascularization.The baseline clinical data of patients'demographics and incisional complications after cerebral revascularization were recorded,and possi-ble influencing factors were included in a binary logistic regression analysis to analyze the influencing factors that may contribute to the occurrence of incisional complications after cerebral revascularization.Results A total of 117 patients who underwent cerebral revascularization were included,including 25 cases(21.4%)in the group with incision complications,including 7 cases(28.0%)of fat liquefaction,4 cases(16.0%)of inci-sion dehiscence,7 cases(28.0%)of incision infection,and 7 cases(28.0%)of necrosis,while 92 cases(78.6%)in the group without incisional complications.Univariate analysis showed that there was no statisti-cally significant difference in gender,age,hypertension,hyperlipidemia,smoking,drinking,disease type,and vascular reconstruction type between the patients with incision complications after cerebral revascularization and those without incision complications(P>0.05).The proportion of patients with diabetes mellitus and the frontal branches of superficial temporal artery not preserved in the incision complications group was higher than in the no incision complications group.BMI,scalp thickness,and operation time in the group with incision complications were higher than those in the no incision complications group,and the difference was statistical-ly significant(P<0.05).Multifactorial analysis showed that scalp thickness(OR=1.484,95%CI:1.024-2.149,P=0.037),BMI(OR=1.323,95%CI:1.042-1.680,P=0.021),and the absence of the frontal branch of the superficial temporal artery(OR=3.582,95%CI:1.146-11.190,P=0.028),were the main risk factors for incisional complications(P<0.05).Conclusion BMI,scalp thickness,and failure to preserve the frontal branch of the superficial temporal artery are independent risk factors for scalp incision complica-tions after cerebral revascularization.

cerebral revascularizationincision complicationsbody mass indexscalp thickness

杨洪超、周通、黎传清、闫一九、谢满意

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徐州医科大学第一临床医学院,江苏徐州 221004

徐州医科大学附属医院神经外科,江苏徐州 221000

颅脑血管重建术 切口并发症 体重指数 头皮厚度

2024

重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
年,卷(期):2024.53(10)
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