大骨瓣减压术治疗重型颅脑损伤对患者炎性因子水平和脑代谢的影响  

Effects of large bone flap decompression on inflammatory factors and brain metabolism in patients with severe craniocerebral injury

作　　者：田向阳[1] 张岭[1] 孙来广[1] 郭武军 薛艺红[1] TIAN Xiang-yang;ZHANG Ling;SUN Lai-guang(Department of Neurosurgery,Henan Xinxiang Central Hospital,Xinxiang 453000,China)

机构地区：[1]河南省新乡市中心医院神经外科,453000

出　　处：《中国实用医药》2019年第14期23-24,共2页China Practical Medicine

摘　　要：目的分析大骨瓣减压术治疗重型颅脑损伤对患者炎性因子水平和脑代谢的影响。方法 88例重型颅脑损伤患者,其中43例采用小骨窗手术治疗的患者为甲组, 45例采用大骨瓣减压术治疗的患者为乙组。比较两组患者手术前后炎性因子及脑代谢指标水平。结果术前1 d,两组患者血清白细胞介素-2(IL-2)、脑氧摄取率(CEO2)比较差异无统计学意义(P>0.05);与术前1 d比较,术后5 d两组患者IL-2显著下降, CEO_2显著升高,差异具有统计学意义(P<0.05);术后5 d,乙组血清IL-2(20.08±0.85)ng/ml显著低于甲组的(26.93±0.94)ng/ml, CEO_2(40.06±3.92)%显著高于甲组的(31.47±3.18)%,差异具有统计学意义(P<0.05)。结论大骨瓣减压术治疗重型颅脑损伤,更有助于降低炎性因子水平,改善脑代谢,效果显著,值得在临床推广应用。Objective To analyze the effect of large bone flap decompression on inflammatory factors and brain metabolism in patients with severe craniocerebral injury. Methods A total of 88 patients with severe craniocerebral injury were randomly divided into group A(43 cases) and group B(45 cases). Group A was treated with small bone window surgery, and group B was treated with large bone flap decompression. The surgical effect and the levels of inflammatory factors and brain metabolic indexes before and after operation were compared between the two groups. Results At 1 d before operation, both groups had no statistically significant in serum IL-2 and cerebral extraction of oxygen(CEO2)(P>0.05). Compared with 1 d before operation, both groups had significantly lower serum interleukin-2(IL-2) level and higher CEO2 at 5 d after operation, and their difference was statistically significant(P<0.05). At 5 d after operation, group B had significantly lower serum as(20.08±0.85) ng/ml than(26.93±0.94) ng/ml in group A, and significantly higer CEO2 as(40.06±3.92)% than(31.47±3.18)% in group A. Their difference was statistically significant(P<0.05). Conclusion Large bone flap decompression shows remarkable effect in the treatment of severe craniocerebral injury, and it is more conducive to reducing the level of inflammatory factors and improving brain metabolism. It is worthy of clinical promotion and application.

关 键 词：大骨瓣减压术 重型颅脑损伤 炎性因子 脑代谢 

分 类 号：R651.15[医药卫生—外科学]