超低温保存自体颅骨修补术后早期癫痫发作的影响因素分析

Risk factors for early postoperative seizures after cryopreserved autologous cranioplasty

摘要:

目的 探讨超低温保存自体颅骨修补术后早期癫痫发作（EPS）的影响因素。方法 回顾性分析2012年1月—2025年6月在成都医学院第二附属医院·核工业四一六医院予超低温保存自体颅骨修补术的282例患者临床资料，依据术后7 d内癫痫发作的临床表现进行术后早期癫痫评估，并将其分为癫痫发作组和无癫痫发作组。采用多因素Logistic回归分析影响EPS发生的相关因素。结果 43例患者术后早期出现癫痫发作，发生率为15.25%。皮瓣塌陷（OR=4.811,95%CI:1.858～12.459）及膨出（OR=4.529,95%CI:1.608～12.755），术后术区出血或积液（OR=2.911,95%CI:1.280～6.622）与自体颅骨修补术EPS的发生相关（均P<0.05）。结论 皮瓣塌陷、膨出以及术后术区出血或积液是自体颅骨修补术后发生EPS的危险因素。

Abstract:

Objective To investigate the risk factors for early postoperative seizures （EPS） after cryopreserved autologous cranioplasty.Methods A retrospective analysis was performed for the clinical data of 282 patients who underwent cryopreserved autologous cranioplasty in The Second Affiliated Hospital of Chengdu Medical College & Nuclear Industry 416 Hospital from January 2012 to June 2025. The clinical manifestations of seizures within 7 days after surgery were used to assess early seizures， and then the patients were divided into seizure group and non-seizure group. The multivariate logistic regression analysis was used to identify the influencing factors for EPS.Results There were 43 patients with EPS， resulting in an incidence rate of 15.25%. Skin flap depression （odds ratio ［OR］ = 4.811， 95% confidence interval ［CI］： 1.858-12.459， P <0.05）， skin flap protrusion （OR = 4.529， 95% CI： 1.608-12.755， P <0.05）， and postoperative hemorrhage or fluid accumulation （OR = 2.911， 95% CI： 1.280-6.622， P <0.05） were associated with EPS after autologous cranioplasty.Conclusions Skin flap depression， skin flap protrusion， and postoperative hemorrhage or fluid accumulation are risk factors for EPS after cryopreserved autologous cranioplasty.