PDF(Pubmed)
Abstract：
UNASSIGNED: Decompressive craniectomy (DC) is a neurosurgical technique that is gaining renewed interest due to the worldwide resurgence of head injuries. We aimed to analyze the quality of management and prognosis of patients who underwent this surgery in the context of limited resources.
UNASSIGNED: This was a prospective, longitudinal, descriptive, and analytical study following STROBE, lasting 36 months at the National Hospital of Niamey in patients who had undergone DC. P ≤ 0.05 was considered significant.
UNASSIGNED: During our study, we collected 74 cases of DC. The mean age was 32.04 years (10-75 years), with male predominance (91.89%). DC was mainly performed following head trauma (95.95%), the main cause of which was road traffic accidents (76%; 54/71). On admission, most patients presented with altered consciousness (95.95%) and pupillary abnormalities (62.16%). The average time between brain damage and brain scan was 31.28 h, with parenchymal contusion being the most frequent lesion (90.54%). The majority of patients (94.59%) underwent decompressive hemicraniectomy. Postoperative complications accounted for 71.62% of all cases, with 33.78% resulting in death. Among survivors, 55.10% had neurological sequelae at the last consultation (27/49). The main factors associated with the risk of death and morbidity were a Glasgow coma score ≤8, pupillary abnormality on admission, the presence of signs of brain engagement, and a long admission delay.
UNASSIGNED: Our study shows that the impact of limited resources on our care is moderate. Future research will concentrate on long-term monitoring, particularly focusing on the psychosocial reintegration of patients post-DC.
UNASSIGNED: This was a prospective, longitudinal, descriptive, and analytical study following STROBE, lasting 36 months at the National Hospital of Niamey in patients who had undergone DC. P ≤ 0.05 was considered significant.
UNASSIGNED: During our study, we collected 74 cases of DC. The mean age was 32.04 years (10-75 years), with male predominance (91.89%). DC was mainly performed following head trauma (95.95%), the main cause of which was road traffic accidents (76%; 54/71). On admission, most patients presented with altered consciousness (95.95%) and pupillary abnormalities (62.16%). The average time between brain damage and brain scan was 31.28 h, with parenchymal contusion being the most frequent lesion (90.54%). The majority of patients (94.59%) underwent decompressive hemicraniectomy. Postoperative complications accounted for 71.62% of all cases, with 33.78% resulting in death. Among survivors, 55.10% had neurological sequelae at the last consultation (27/49). The main factors associated with the risk of death and morbidity were a Glasgow coma score ≤8, pupillary abnormality on admission, the presence of signs of brain engagement, and a long admission delay.
UNASSIGNED: Our study shows that the impact of limited resources on our care is moderate. Future research will concentrate on long-term monitoring, particularly focusing on the psychosocial reintegration of patients post-DC.
摘要：
■去骨瓣减压术（DC）是一种神经外科技术，由于全球范围内头部受伤的死灰复燃，引起了人们的新兴趣。我们旨在分析在资源有限的情况下接受此手术的患者的管理质量和预后。
■这是一个前景，纵向,描述性,描述性以及Strobe之后的分析研究，在尼亚美国家医院接受DC治疗的患者持续36个月。P≤0.05被认为是显著的。
■在我们的研究中，我们收集了74例DC。平均年龄为32.04岁（10-75岁），男性占主导地位（91.89%）。DC主要在头部外伤后进行（95.95%），主要原因是道路交通事故(76%；54/71)。一入场,大多数患者表现为意识改变(95.95%)和瞳孔异常(62.16%)。脑损伤与脑部扫描之间的平均时间为31.28h，实质挫伤是最常见的病变（90.54％）。大多数患者（94.59％）接受了去骨瓣减压术。术后并发症占全部病例的71.62%,33.78%导致死亡。在幸存者中，55.10％在上次咨询时出现神经系统后遗症（27/49）。与死亡和发病风险相关的主要因素是格拉斯哥昏迷评分≤8分，入院时瞳孔异常，大脑参与的迹象的存在，还有很长的入学延迟.
■我们的研究表明，有限的资源对我们的护理的影响是适度的。未来的研究将集中在长期监测上，特别关注DC后患者的心理社会融合。
■这是一个前景，纵向,描述性,描述性以及Strobe之后的分析研究，在尼亚美国家医院接受DC治疗的患者持续36个月。P≤0.05被认为是显著的。
■在我们的研究中，我们收集了74例DC。平均年龄为32.04岁（10-75岁），男性占主导地位（91.89%）。DC主要在头部外伤后进行（95.95%），主要原因是道路交通事故(76%；54/71)。一入场,大多数患者表现为意识改变(95.95%)和瞳孔异常(62.16%)。脑损伤与脑部扫描之间的平均时间为31.28h，实质挫伤是最常见的病变（90.54％）。大多数患者（94.59％）接受了去骨瓣减压术。术后并发症占全部病例的71.62%,33.78%导致死亡。在幸存者中，55.10％在上次咨询时出现神经系统后遗症（27/49）。与死亡和发病风险相关的主要因素是格拉斯哥昏迷评分≤8分，入院时瞳孔异常，大脑参与的迹象的存在，还有很长的入学延迟.
■我们的研究表明，有限的资源对我们的护理的影响是适度的。未来的研究将集中在长期监测上，特别关注DC后患者的心理社会融合。
