临床误诊误治2024，Vol.37Issue(20)：36-40,5.DOI:10.3969/j.issn.1002-3429.2024.20.009
重型颅脑损伤患者标准大骨瓣减压术后脑梗死发生危险因素分析
Analysis of Risk Factors of Cerebral Infarction in Patients with Severe Craniocerebral Injury after Standard Large Bone Flap Decompression
摘要
Abstract
Objective To investigate the risk factors of cerebral infarction in patients with severe craniocerebral inju-ry(SCCI)after standard large bone flap decompression,and in order to diagnose postoperative cerebral infarction early and prevent misdiagnosis and mistreatment after surgery.Methods A total of 135 patients with SCCI who underwent standard large bone flap decompression from January 2020 to December 2022 were included in the study.According to occurrence of cerebral infarction after surgery,the patients were divided into the occurrence group and the non-occurrence group.The gener-al data and laboratory indicators of the two groups were compared,and the risk factors of cerebral infarction in SCCI patients after standard large bone flap decompression were analyzed.Results A total of 37(27.41%)patients of 135 patients with SCCI had cerebral infarction after standard large bone flap decompression.The proportion of cerebral hernia,subarachnoid hemorrhage and the levels of Caspase-1,interleukin-18(IL-18)and interleukin-37(IL-37)in occurrence group were higher than those in non-occurrence group,and the Glasgow Coma Index(GCS)score at admission was lower than that in non-occurrence group(P＜0.01).Multivariate Logistic regression analysis showed that high GCS score at admission was a protec-tive factor for cerebral infarction after standard large bone flap decompression in SCCI patients(P＜0.05).High levels of Caspase-1,IL-18 and IL-37 were risk factors for cerebral infarction in patients with SCCI after standard large bone flap decom-pression(P＜0.05,P＜0.01).Conclusion Patients with SCCI have a higher risk of cerebral infarction after standard large bone flap decompression.Low GCS score and high levels of Caspase-1,IL-18 and IL-37 at admission may increase the risk of cerebral infarction.Monitoring the patient's GCS score,Caspase-1,IL-18,and IL-37 can help early diagnosis of postoperative cerebral infarction,so as to prevent misdiagnosis and mistreatment after surgery.关键词
重型颅脑损伤/标准大骨瓣减压术/脑梗死/危险因素/格拉斯哥昏迷指数评分/半胱氨酸蛋白酶-1/白细胞介素-18/白细胞介素-37Key words
Severe craniocerebral injury/Standard large bone flap decompression/Cerebral infarction/Risk factors/Glasgow coma index score/Cysteine proteinase-1/Interleukin-18/Interleukin-37分类
临床医学引用本文复制引用
孟发财,郭宝瑞,李英..重型颅脑损伤患者标准大骨瓣减压术后脑梗死发生危险因素分析[J].临床误诊误治,2024,37(20):36-40,5.基金项目
陕西省自然科学基础研究计划项目(2024JC-YBQN-0952) （2024JC-YBQN-0952）
