The Clinical Research Of Influence Factor Of External Cerebral Herniation Following Large Decompressive Craniectomy In Patients With Severe Traumatic Brain Injury

Objective:To explore decompressive craniectomy for severe craniocerebral injury(Large decompressive Craniectomy,LDC)the risk factors postoperative concurrent encephalocele and its influence on the prognosis of patients,and improve on severe craniocerebral injury(s TBI)understanding of patients with encephalocele after decompressive craniectomy,in order to prevent and reduce the incidence of postoperative prolapse,so as to improve the prognosis of patients severe craniocerebral injury.Method:A retrospective analysis was made in the 265 patients with decompressive craniectomy and 181 patients with external cerebral herniation.The relative clinical factors of preoperative Glasgow Coma Score(GCS),basal cistern disappear,midline shift>1cm,Artificial epidural tension suture,postoperative delayed intracerebral hematoma(DICH),postoperative intracranial infection,postoperative hydrocephalus,,were exploratory analyzed,and the influence on the Glasgow Outcome Scale(GOS)after six month.Result:1.Among the 265 patients,a total of 181 patients(68.3%)occurred external cerebral herniation after operation.2.The analysis results of the clinical data of patients in two groups showed that gender and age have no difference.The result show Glasgow Coma Score(GCS),basal cistern disappear,midline shift>1cm,Artificial epidural tension suture,postoperative delayed intracerebral hematoma(DICH),postoperative intracranial infection,postoperative hydrocephalus,were significantly correlated with the appearance of external cerebral herniation(P< 0.05).3.Multivariable Logistic regression analysis showed that GCS(OR=1.837,95% CI 1.021-3.304,P=0.042)?Artificial epidural tension suture(OR=1.892%,95% CI 1.072-3.340,P=0.028)?DICH(OR=2.147,95%CI 1.130-4.079,P=0.020).4.Analysis results of GOS scores 6 months after operation of the patients showed that the GOS of the patients in external cerebral herniation group was significantly worse than that in non-external cerebral herniation group(P<0.01).Conclusion:1?Incidence of postoperative encephalocele increase in patients with lower GCS score ?postoperative DTICH,and without Using artificial epidural tension suture can reduce the occurrence of postoperative encephalocele2?Incidence of postoperative encephalocele increase in patients with DICH...