颅脑损伤患者去骨瓣减压术后并发进展型硬膜下积液的不同方案治疗及并发症分析  

Analysis of Different Treatment Schemes and Complications of Progressive Subdural Effusion after Decompressive Craniectomy in Patients with Craniocerebral Injury

作　　者：林吴用[1] 马宝林[1] 房正华[1] 宋湖平[1] LIN Wuyong;MA Baolin;FANG Zhenghua;SONG Huping(Xinglin Branch of the First Affiliated Hospital of Xiamen University,Xiamen 361000,China;不详)

机构地区：[1]厦门大学附属第一医院杏林分院,福建厦门361000

出　　处：《中外医学研究》2021年第17期154-156,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨颅脑损伤患者去骨瓣减压术后并发进展型硬膜下积液的不同方案治疗及并发症发生情况。方法:回顾性分析2017年1月-2019年1月笔者所在医院收治的60例颅脑损伤去骨瓣减压术后并发进展型硬膜下积液患者的临床资料,根据治疗方式的不同将其分为对照组(n=28)与观察组(n=32)。对照组接受钻孔引流术或局部穿刺引流术治疗,术后应用弹力绷带适当加压包扎,观察组接受钻孔引流术或局部穿刺引流术治疗,术后应用弹力绷带适当加压包扎及腰大池持续引流。比较两组治疗效果、并发症及预后情况。结果:观察组头部引流管留置时间(7.51±1.20)d,硬膜下积液基本消失时间(6.68±1.08)d,住院时间(19.44±3.08)d,均优于对照组的(11.52±2.36)、(10.36±2.02)、(23.68±3.65)d,差异有统计学意义(P<0.05)。观察组一次性治愈率为84.38%,高于对照组的64.29%,差异有统计学意义(P<0.05)。观察组并发症发生率为6.25%,低于对照组的46.43%,差异有统计学意义(P<0.05)。观察组术后3、6个月GOS评分为(3.90±0.42)、(4.08±0.77)分,均高于对照组的(3.52±0.51)、(3.68±0.70)分,差异有统计学意义(P<0.05)。结论:颅脑损伤患者去骨瓣减压术后并发进展型硬膜下积液应用钻孔引流术或局部穿刺引流术后应用弹力绷带适当加压包扎及腰大池持续引流,可提升治疗效果,降低术后并发症发生率,有利于改善疾病预后。Objective:To investigate the different treatment schemes and complications of progressive subdural effusion after decompressive craniectomy in patients with craniocerebral injury.Method:The clinical data of 60 patients with progressive subdural effusion after craniocerebral injury decompressive craniectomy admitted in our hospital from January 2017 to January 2019 were retrospectively analyzed,and they were divided into the control group(n=28)and the observation group(n=32)according to different treatment methods.The control group was treated with drilling drainage or local puncture drainage,and appropriate pressure dressing of elastic bandage was applied after surgery.The observation group was treated with drilling drainage or local puncture drainage,and appropriate pressure dressing of elastic bandage and continuous drainage of lumbar cistern after surgery.The therapeutic effect,complications and prognosis of the two groups were compared.Result:The indwelling time of the head drainage tube in the observation group was(7.51±1.20)d,the time subdural effusion disappeared was(6.68±1.08)d,and the hospital stay time was(19.44±3.08)d,which were better than(11.52±2.36),(10.36±2.02),(23.68±3.65)d in the control group,the differences were statistically significant(P<0.05).The one-time cure rate of the observation group was 84.38%,which was higher than 64.29%of the control group,and the difference was statistically significant(P<0.05).The incidence of complications in the observation group was 6.25%,which was lower than 46.43%in the control group,and the difference was statistically significant(P<0.05).GOS scores of the observation group were(3.90±0.42)points and(4.08±0.77)points at 3 and 6 months after surgery,which were higher than(3.52±0.51)points and(3.68±0.70)points of the control group,and the differences were statistically significant(P<0.05).Conclusion:Drilling drainage or local puncture drainage,and appropriate pressure dressing of elastic bandage and continuous drainage of lumbar cistern after surgery

关 键 词：颅脑损伤 去骨瓣减压术 进展型硬膜下积液 加压包扎 腰大池持续引流 

分 类 号：R651.15[医药卫生—外科学]