阶梯式颅内减压技术在急性重度颅脑损伤中的应用疗效  

The Application and Effect of Ladder-type Intracranial Decompression Technology in Acute Serious Craniocerebral Injury

作　　者：张鲲鹏[1] 刘德昭[2] 

机构地区：[1]南方医科大学附属潮州市中心医院神经外科,广东潮州521021 [2]中山大学附属第三医院麻醉科,广东广州510630

出　　处：《临床医学工程》2012年第1期42-43,共2页Clinical Medicine & Engineering

基　　金：广东省医学科研基金项目(B2011104);广东省科技计划项目(2011B031800058)

摘　　要：目的探讨阶梯式颅内减压技术对急性重度颅脑损伤患者预后的影响。方法选择2009年3月至2011年9月在我院就诊的80例重度颅脑损伤合并恶化型颅内高压的患者,随机分成两组进行前瞻性研究:传统减压组和阶梯式颅内减压组,每组各40例。比较两组术中急性脑膨出及迟发血肿的发生率;术后脑梗死发生率;术后6个月格拉斯哥治疗结果分级(GOS)评分。结果①阶梯减压组患者术中急性脑膨出、迟发性血肿的发生率比传统减压组明显降低,差异具有统计学意义(P<0.05);阶梯减压组术后脑梗死比传统减压组有所降低,但差异无统计学意义(P>0.05);②6个月后,阶梯减压组的植物状态及死亡率明显低于传统减压组(P<0.05);而预后良好率则明显高于传统减压组(P<0.05)。结论阶梯式颅内减压技术通过逐步释放颅内压力,降低了围术期颅脑外伤的并发症,对提高重度颅脑损伤的救治及预后具有意义。Objective To investigate the application of ladder-type intracranial decompression and its therapeutic effect. Methods Eighty patients with serious craniocerebral injury were randomly divided into two groups： ladder-type group （n =40） and control group （n =40）. The Glasgow Outcome Scale （GOS） after six months and rate of intraoperative brain swelling and delayed hematoma were observed. Results ①The rate of intraoperative brain swelling and delayed hematoma in ladder-type group were lower than those in the control group （P 〈0.05）; ②By GOS, the good recovery rate of ladder-type group was higher than that in the control group （P 〈0.05）, and the rate of death and vegetative state were lower than that in control group （P〈0.05）. Conclusion The ladder-type intracranial decompression can reduce the perioperative craniocerebral trauma complications via gradual release of intracranial pressure, which has significance in the treatment and prognosis of serious eraniocerebral injury.

关 键 词：重度颅脑损伤 阶梯式颅内减压 疗效 

分 类 号：R651.15[医药卫生—外科学]