Analysis Of Risks Factors Of The Subdural Effusion After Decompression Craniectomy

Objectives:The purpose of this research was to explore of risks factors of the subdural effusion for Patients with severe craniocerebral trauma after decompression craniectomy.so as to take preventive measures in early clinical practice,reduce the incidence of subdural effusion after craniectomy,and improve the prognosis of patients with craniocerebral trauma.Methods:A retrospective analysis of the 132 patients with severe craniocerebral trauma treated with decompression craniectomy at the neurosurgery department of xxxxxxxx university general hospital from January 2015 to 2018.According to the diagnostic criteria of subdural effusion,patients were divided into subdural effusion group and no-subdural effusion group.Age,Glasgow coma score(GCS)before operation,GOS score,midline shift,length of stay were measured by two independent samples t test.Gender,history of hypertension,changes of pupil size and light reaction before operation,timing and duration of operation,Location and size of bone window,subarachnoid hemorrhage,pulmonary infection and perioperative intracranial infectio were measured by ?2test,and then the factors with statistical significance were analyzed retrospectively by multivariate analysis.Results:The study results showed that the incidence of patient with server brain injure after DC was 58.3%(77/132).Univariate analysis showed that patients average age,with low preoperative GCS,cisterna structure was pressed of uncler,SAH(Subarachnoid hemorrhage),brain midline shift greater than 10 mm,intraventricular hemorrhage,Standard large trauma Craniectomy(10cm~12cm×12cm~15),Preoperative pupil change,postoperative intracranial is a major risk factor for subdural effusion.Relative risk: subarachnoid hemorrhage (OR 9.28)> perioperative intracranial infection(OR 5.47)> Standard large trauma Craniectomy(OR 3.22)> preoperative GCS score:(OR 1.31).Conclusion: Subarachnoid hemorrhage,intracranial infection,The average GCS score before operation was less than 8,which was the high risk factor for the occurrence of subdural effusion after decompression of craniocerebral trauma.The risk grade was: subarachnoid hemorrhage >intracranial infection > Standard large trauma Craniectomy(10cm~12cm×12cm~15)>preoperative GCS score.