导致颅骨修补术后并发症的多因素风险分析

A multi-factor risk analysis of complications after cranioplasty

摘要:

目的 分析导致颅骨修补术后并发症的风险因素，为颅骨修补术后并发症的防治提供参考依据。方法 选取我院2012年1月至2016年8月收治的177例颅骨修补术患者进行回顾性分析，按照术后并发症的发生情况分为有并发症组和无并发症组，计算术后并发症的发生率，比较两组临床资料的差异，将存在统计学差异的因素纳入Logistic多因素分析，总结导致颅骨修补术后发生并发症的风险因素。结果 177例患者中，20例患者合并并发症，发生率为11.30%，其中皮下积液13例，癫痫4例，感染2例，皮瓣坏死1例。多因素回归分析显示，合并脑积水、缺损面积≥40 cm²是导致颅骨修补术后并发症发生的风险因素；钛合金修补材料、手术间隔< 3个月为保护因素（P < 0.05）。结论 颅骨修补术后并发症的发生与患者疾病状况、手术方案均密切相关，重视术前合并症的治疗并科学设计手术方案，有望降低术后并发症的发生风险，从而改善患者的预后质量。

Abstract:

Objective To analyze the risk factors for complications after cranioplasty, and to provide a reference for the prevention and treatment of such complications after cranioplasty.Methods A retrospective analysis was performed for 177 patients who were treated with cranioplasty in our hospital from January 2012 to August 2016. According to the presence or absence of complications after cranioplasty, the patients were divided into complication group and non-complication group. The incidence rates of postoperative complications were calculated, and the clinical data were compared between the two groups. The factors with statistical difference were included in the logistic regression analysis, and the risk factors for complications after cranioplasty were summarized.Results Of the 177 patients, 20 (11.30%) experienced complications, among whom 13 had subcutaneous hydrops, 4 had epilepsy, 2 had infection, and 1 had skin flap necrosis. The multivariate regression analysis showed that hydrocephalus and defect area ≥40 cm² were risk factors for the development of complications after cranioplasty, while titanium alloy repair material and operation interval <3 months were protective factors (P<0.05).Conclusions The incidence of complications after cranioplasty is closely associated with patients' disease status and surgical scheme. A focus on the treatment of preoperative comorbidities and scientific design of surgical scheme may help to reduce the risk of postoperative complications and improve patients' prognosis.