标准大骨瓣减压术对重型颅脑损伤患者颅内压及部分血清学指标的影响  

Effect of standard large bone flap decompression on intracranial pressure and and some serological indexes in patients with severe head injury

作　　者：钟琪[1] 李宗平[1] 张烨 刘平[1] Zhong Qi;Li Zongping;Zhang Ye;Liu Ping(Department of Neurosurgery,Mianyang Central Hospital,Sichuan Mianyang 621000)

机构地区：[1]绵阳市中心医院神经外科,四川绵阳621000

出　　处：《中国社区医师》2020年第25期65-66,共2页Chinese Community Doctors

摘　　要：目的:探讨标准大骨瓣减压术对重型颅脑损伤患者颅内压及神经胶质原纤维酸性蛋白(GFAP)、S100钙结合蛋白β(S100β)、髓鞘碱性蛋白(MBP)的影响。方法:2017年1月-2018年12月选择本院收治重型颅脑损伤患者100例为研究对象,随机分为两组,各50例。对照组采用常规骨瓣开颅术;试验组采用标准大骨瓣减压术治疗。比较两组治疗效果、神经功能缺损评分(NIHSS)、脑功能障碍评分(DRS)、颅内压、血清学指标水平及不良反应发生情况。结果:试验组治疗总有效率高于对照组,差异有统计学意义(P<0.05);试验组术后NIHSS和DRS评分、颅内压、S100β及MBP水平均低于对照组,GFAP水平高于对照组,差异均有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:标准大骨瓣减压术对于治疗重型颅脑损伤患者有显著效果。Objective:To investigate the effect of standard large bone flap decompression on intracranial pressure,GFAP,S100βand MBP in patients with severe craniocerebral injury.Methods:From January 2017 to December 2018,100 patients with severe craniocerebral injury in our hospital were selected,they were randomly divided into the two groups with 50 cases in each group.The control group was treated with conventional bone flap craniotomy.The experimental group was treated with standard large bone flap decompression.The treatment effect,National Institute of Health Stroke Scale(NIHSS),Brain Dysfunction Score(DRS),intracranial pressure,serum index level and occurrence of adverse reactions were compared between the two groups.Results:The total effective rate of treatment in the experimental group was higher than the control group,and the difference was statistically significant(P<0.05).The scores of postoperative NIHSS and DRS,intracranial pressure,astrogenic proteinβ(S100β)and myelin basic protein(MBP)levels in the experimental group were lower than the control group,and the serum glial fibrillary acidic protein(GFAP)level was higher than that in the control group,the differences were statistically significant(P<0.05).The incidence of adverse reactions between the two groups was not statistically significant(P>0.05).Conclusion:Standard large bone flap decompression has a significant effect on patients with severe craniocerebral injury.

关 键 词：标准大骨瓣减压术 重型颅脑损伤 GFAP S100Β MBP 

分 类 号：R651.15[医药卫生—外科学]