超低温保存自体颅骨修补术术后早期癫痫发作的危险因素分析

Risk Factors for Early Postoperative Seizures After Cryopreserved Autologous Skull Cranioplasty

摘要:

目的 探讨超低温保存自体颅骨修补术术后早期癫痫发作(EPS)的危险因素。方法 回顾性分析2014年至2024年在我院行超低温保存自体颅骨修补术的212例患者的临床资料,依据术后7天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EPS组(31例)和 非EPS组(181例)。采用单因素和多因素 Logistic 回归分析 , 探讨影响术后EPS发生的相关因素。结果 31例患者术后早期出现癫痫发作,发生率为14.62%。两组患者在颅骨缺损主要部位、皮瓣塌陷情况,修补术中硬脑膜是否破裂、术后术区是否出血或积液、修补术中是否使用自固化磷酸钙骨水泥等方面存在差异(P<0.05)。多因素 Logistic 回归分析显示 :皮瓣塌陷(OR=4.83,95CI%:1.79 ~ 13.05)及膨出(OR=4.47,95CI%:1.26 ~ 15.86),术后术区出血或积液(OR=4.83,95CI%:1.79 ~ 13.05)与自体颅骨修补术术后EPS的发生相关(P<0.05)。结论 皮瓣塌陷＞0.5cm及膨出＞0.5cm、术后术区出血或积液是自体颅骨修补术术后发生EPS的独立危险因素 (P<0.05)。

Abstract:

LI Jiayu,CAO Xi,CHEN Liang,HUO Kunliang,YANG Ziyin

Department of Neurosurgery, the Second Affiliated Hospital of Chengdu Medical College, China National Nuclear Corporation 416 Hospital, Chengdu 610000,Sichuan,China??

Corresponding author: YANG Ziyin(1984-), associate chief physician, bachelor"s degree,email:[e-mail]
: ObjectiveTo investigate the risk factors for early postoperative seizures following cryopreserved autologous skull cranioplasty.MethodsA retrospective analysis was conducted on the clinical data of 212 patients who underwent cryopreserved autologous skull cranioplasty at our hospital from 2014 to 2024. Patients were divided into a seizure group (31 cases) and a non-seizure group (181 cases) based on the occurrence of seizures within 7 days postoperatively. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for early postoperative seizures.ResultsEarly postoperative seizures occurred in 31 patients (14.62%). Significant differences were observed between the two groups in terms of skull defect location, skin flap depression/protrusion, intraoperative dural rupture, postoperative hemorrhage or fluid accumulation, and use of self-setting calcium phosphate cement (CPC) during surgery (allP< 0.05). Multivariate logistic regression analysis identified skin flap depression (OR = 4.83, 95% CI: 1.79–13.05), protrusion (OR = 4.47, 95% CI: 1.26–15.86), and postoperative hemorrhage or fluid accumulation (OR = 4.83, 95% CI: 1.79–13.05) as independent risk factors for early seizures (P< 0.05).ConclusionSkin flap depression, protrusion, and postoperative hemorrhage or fluid accumulation are independent risk factors for early seizures following cryopreserved autologous skull cranioplasty (P< 0.05).

Keywords: Autologous Bone; Cranioplasty; Early Postoperative Seizures; Risk Factors