| Objective:Traumatic epilepsy is one of the common complications of traumatic brain njury.It can further aggravate brain tissue damage,leading to severe ischemia and hypoxia of brain tissue,aggravating brain edema,thereby increasing the risk of cerebral palsy.It can cause serious economic and psychological burdens on patients,families and society.Therefore,we collect clinical data of traumatic epilepsy,and retrospectively analyze the data,comprehensively evaluate the risk factors of traumatic epilepsy.It is necessary to provide relevant evidence for the improving quality of life.The purpose of this study is to investigate the risk factors of secondary epilepsy after brain injury,and to provide evidence for the prevention and treatment of traumatic epilepsy.Methods:The clinical data of 368 patients with traumatic brain injury admitted in the Department of Neurosurgery of our hospital from January 2015 to December 2017were analyzed retrospectively.52 cases were diagnosed with traumatic epilepsy,focusing on the comprehensive analysis from factors such as age,sex,cause of injury,site of injury,type of injury,and degree of injury to eliminate or reduce the risk of traumatic epilepsy.All the data were processed by SPSS13.0 statistical software.The count data were expressed as the ratio or rate(%).The data were compared by X~2 test.The influencing factors with statistical significance were analyzed by multivariate logistic regression,and the regression coefficients,OR values and P values were calculated.The difference was statistically significant at P<0.05.Results:Risk factors associated with traumatic epilepsy by Univariate analysis(X~2 test):(1)The relationship between age and PTE occurrence:35 cases(11.67%)had PTE in the adult group and 17 cases(25%)in the minor group.The incidence of PTE in the minor group was significantly higher than that in the adult group(X2=8.122,P<0.01).The difference was statistically significant.(2)The relationship between gender and PTE:PTE occurred in 30 cases(13.89%)of216 males and 22 cases(14.47%)of 152 females.There was no significant difference in the incidence of PTE between males and females(X2=0.025,P>0.05).(3)The relationship between trauma types and PTE occurrence:PTE occurred in 20cases(28.99%)of 69 cases of open brain injury group and 32 cases(10.7%)of 299 cases of closed brain injury group.The incidence of PTE in open brain injury group was significantly higher than that in closed brain injury group(X2=15.445,P<0.01).The difference was statistically significant.(4)The relationship between the degree of trauma and PTE occurrence:PTE 18(7.53%)occurred in 239 cases of mild brain injury group,PTE 13(17.33%)in 75 cases of moderate brain injury group and PTE 21(38.89%)in 54 cases of severe brain injury group.The incidence of PTE in severe brain injury group was significantly higher than that in mild brain injury group(X2=36.542,P<0.01).The difference was statistically significant.(5)The relationship between PTE and the causes of injury:PTE occurred in 35 of273 cases(12.82%)in traffic accident group,7 of 37 cases(18.92%)in blunt injury group and 10 of 58 cases(17.24%)in fall injury group.There was no significant difference in the incidence of PTE among the three groups(X2=1.5824,P>0.05).(6)The relationship between PTE and injury site:PTE occurred in 28 cases(22.76%)of 123 patients with temporal lobe brain injury,19 cases(11.66%)of 163 patients with frontal lobe brain injury,3 cases(7.5%)of 40 patients with parietal lobe brain injury,2cases(4.76%)of 42 patients with occipital lobe brain injury and 2 cases(4.76%)of temporal lobe brain injury.The incidence of PTE in patients with temporal lobe brain injury was significantly higher than that in patients with occipital lobe brain injury(X2=12.866,P<0.01).The difference was statistically significant.(7)The relationship between PTE and cortical contusion and laceration:35 cases(21.88%)had PTE in 160 cases with cortical contusion and 27 cases(8.17%)had PTE in208 cases without cortical contusion and laceration.The incidence of PTE in patients with cortical contusion and laceration was significantly higher than that in patients without cortical contusion and laceration(X2=13.993,P<0.01).The difference was statistically significant.(8)The relationship between PTE and skull fracture:PTE occurred in 23 cases(22.55%)of 102 cases of depressed skull fracture group,19 cases(10.92%)of 174 cases of linear skull fracture group,and 10 cases(10.87%)of 92 cases of non-skull fracture group.The incidence of PTE in depressed skull fracture group was significantly higher than that in non-skull fracture group.Patients(X2=8.2064,P<0.05),the difference was statistically significant.(9)The relationship between PTE and intracranial hematoma:PTE occurred in 20out of 78 patients with intracranial hematoma(25.64%)and 32 out of 290 patients without intracranial hematoma(11.03%).The incidence of PTE in patients with intracranial hematoma was significantly higher than that in patients without intracranial hematoma(X2=10.808,P<0.01).The difference was statistically significant.(10)The relationship between early epilepsy-like seizures and PTE occurrence:PTE occurred in 11 out of 44 patients with early epilepsy-like seizures(25.00%)and 41 out of324 patients without early epilepsy-like seizures(12.65%).The incidence of PTE in patients with early epilepsy-like seizures was significantly higher than that in patients without early epilepsy-like seizures(X2=4.866,P<0.05).The difference was statistically significant.The most important risk factors for traumatic epilepsy by multivariate logistic regression:Multivariate logistic regression was used to analyze the related factors of PTE,such as age,open brain injury,severe brain injury,injury site,cortical contusion and laceration,depressed cranial fracture,intracranial hematoma and early epileptic seizures.The independent variable regression coefficient of age was 0.886,OR value was 2.425,P=0.020,P<0.05.The difference was statistically significant.The regression coefficient of independent variable open brainl injury was-1.155,OR value was 0.315,P=0.008,P<0.05,the difference was statistically significant.The regression coefficient of independent variable severe brain injury was-1.490,OR value was 0.225,P=0.022,P<0.05,the difference was statistically significant.The results showed that the above three factors were the most important risk factors for PTE.The regression coefficient of independent variables injury site was 0.854,OR value was 2.348,P=0.298,P>0.05,with no significant difference.The regression coefficient of independent variable cortical contusion and laceration was-0.556,OR value was 0.574,P=0.241,P>0.05.There was no significant difference.The regression coefficient of independently variable skull depressed fracture was-0.775,OR value was 0.461,P=0.194,P>0.05.There was no significant difference.The regression coefficient of independent variable intracranial hematoma was-0.728,OR value was 0.483,P=0.176,P>0.05.There was no significant difference.The regression coefficient of early epilepsy-like seizures was 0.929,OR value was 2.531,P=0.093,P>0.05.There was no significant difference.These five factors are non-major risk factors for PTE.Conclusion It is necessary to prevent high-risk factors of PTE to reduce the occurrence of PTE.According to our analysis,the incidence of traumatic epilepsy is affected by multiple factors,such as age,type of injury,degree of injury,cortical contusion and laceration,depression of skull,intracranial hematoma,and early epilepsy.In the course of clinical treatment of brain injury,these risk factors should be paid more attention.Especially age,open brain injury and severity of brain injury are the most important factors leading to PTE.Active prevention and treatment measures should be taken for patients with brain injury with these risk factors.Control and eliminate these risk factors as much as possible can effectively prevent and treat traumatic epilepsy. |
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