腰大池持续引流术联合骨瓣减压控制术对重型颅脑损伤患者并发症和预后的影响  

Effect of Continuous Drainage with Lumbar Cistern and Bone Flap Decompression Control on Complications and Prognosis in Patients with Severe Head Injury

作　　者：王陆 WANG Lu(Department of Neurosurgery, Shunyi District Hospital, Beijing, 101300 China)

机构地区：[1]北京市顺义区医院神经外科,北京101300

出　　处：《世界复合医学》2019年第1期99-101,共3页World Journal of Complex Medicine

摘　　要：目的探讨腰大池持续引流术联合骨瓣减压控制术治疗重型颅脑损伤的临床效果。方法选择2016年1月—2017年6月该院收治的60例重型颅脑损伤患者,随机分为对照组和观察组,每组30例;对照组患者采用骨瓣减压控制术,观察组患者采用腰大池持续引流术联合骨瓣减压控制术;分别于术后3 d、5 d、7 d检测两组患者的颅内压(ICP),并根据6个月后的格拉斯哥预后评分(GOS)评估两组患者的预后情况及并发症发生率。结果观察组患者术后3 d、5 d、7 d的ICP均明显低于对照组,差异有统计学意义(t=5.599、5.747、4.835,P<0.05);术后6个月,观察组患者的预后良好率63.33%明显高于对照组的36.67%,差异有统计学意义(χ~2=4.267,P<0.05);观察组患者术后的并发症发生率为26.67%明显低于对照组的53.33%,差异有统计学意义(χ~2=4.444,P<0.05)。结论腰大池持续引流术联合骨瓣减压控制术可有效降低重型颅脑损伤患者的ICP,改善患者预后状况,安全性高,值得推广应用。Objective To investigate the clinical effect of continuous drainage of the lumbar cistern combined with bone flap decompression control in the treatment of severe craniocerebral injury. Methods Sixty patients with severe craniocerebral injury admitted to our hospital from January 2016 to June 2017 were randomly divided into the control group and the observation group, 30 in each group.The control group was treated with bone flap decompression control. Patients in the observation group were treated with continuous drainage of the lumbar cistern and decompression of the flap;the intracranial pressure(ICP) of the two groups were measured at 3, 5,and 7 d after surgery, and the prognosis was based on Glasgow after 6 months. The score(GOS) was used to assess the prognosis and complication rate in the two groups. Results The ICP of the observation group was significantly lower than that of the control group at3 d, 5 d, and 7 d after operation,the different was statistically significant(t=5.599, 5.747, 4.835, P<0.05). The prognosis of the observation group was good at 6 months after operation. The rate of 63.33% was significantly higher than that of the control group 36.67%,the different was statistically significant(χ^2=4.267, P<0.05). The postoperative complication rate of the observation group was 26.67%,which was significantly lower than that of the control group 53.33%,the different was statistically significant(χ^2=4.444, P<0.05). Conclusion Continuous drainage of the lumbar cistern combined with bone flap decompression control can effectively reduce the ICP of patients with severe craniocerebral injury, improve the prognosis of patients, and has high safety. It is worthy of popularization and application.

关 键 词：腰大池引流术 骨瓣减压控制术 重型颅脑损伤 

分 类 号：R651.1[医药卫生—外科学]