Objective To study the risk factors of hematoma enlargement after traumatic brain injury treated with decompressive craniectomy.Methods Retrospective analysis of clinical data of 117 cases of traumatic brain injury admitted to our hospital from January 2022 to August 2023.All patients underwent decompressive craniectomy and were divided into an occurring group(n=62)and a non occurring group(n=55)based on postoperative CT examination to determine whether the hematoma had increased.Compare the general data of two groups[gender,age,comorbidities(hypertension,h yperlipidemia,coronary heart disease),pupil status,time from onset to craniotomy,blood sugar,maximum diameter of bone flap],as well as the differences between Rotterdam Computed Tomography Score(Rotterdam CT)and Glasgow Coma Scale(GCS).Analyzed the risk factors for increased hematoma after craniocerebral injury treated with decompressive craniectomy using multivariate Logistic regression.Results There was no statistically significant difference in gender,concomitant hypertension,hyperlipidemia,and coronary heart disease between the two groups of patients(P>0.05).The proportion of patients with age≥65 years old,dilated pupils,time from onset to craniotomy<4 hours,as well as the Rotterdam CT score,blood sugar,and maximum diameter of bone flap in the incidence group were significantly higher than those in the non hematoma enlargement group.The GCS score was lower than that in the non incidence group,and the difference was statistically significant(P<0.05).The results of multivariate logistic regression analysis showed that age,Rotterdam CT score,GCS score,pupil status,time from onset to craniotomy,blood sugar,and maximum diameter of bone flap were risk factors for postoperative hematoma enlargement in patients with traumatic brain injury,all of which were P<0.05.Conclusion Postoperative hematoma enlargement in patients with traumatic brain injury is influenced by various factors,including age,pupil status,GCS score,Rotterdam CT score,time from onset to craniotomy,blood glucose,and maximum diameter of bone flap,which can predict the postoperative hematoma situation of the disease and should be closely monitored clinically.
Decompression surgery with bone flap removalCraniocerebral injuryHematoma enlargementPupil statusMaximum diameter of bone flap
万方数据
维普
