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Objective: To detect the influencing factors for posttraumatic hydrocephalus in patients with severe traumatic brain injuries and provide theoretical reference for clinical treatment. Methods:Retrospective study was made on 139 patients with severe traumatic brain injuries in our hospital. The patients were divided into two groups: hydrocephalus group and non-hydrocephalus group. Single factor analysis and multiple factor analysis were used to determine the related factors and hydrocephalus. Multiple factor analysis was conducted with logistic regression. Results:Posttraumatic hydrocephalus was found in 19.42% of patients. Age(OR=1.050, 95% CI: 1.012-1.090), decompressive craniectomy (OR=4.312, 95% CI: 1.127-16.503), subarachnoid hemorrhage(OR=43.421, 95% CI: 7.835-240.652) and continuous lumbar drainage of cerebrospinal fluid (OR=0.045, 95% CI: 0.011-0.175) were screened out from nine factors as the influencing factors for posttraumatic hydrocephalus. Conclusions:Risk factors for PTH are as follows: age, decompressive craniectomy and subarachnoid hemorrhage (SAH). Continuous lumbar drainage of cerebrospinal fluid can greatly reduce posttraumatic hydrocephalus.