改良大骨瓣减压手术治疗STBI对患者认知功能和生活能力的影响  

Effect of modified large bone flap decompression surgery on cognitive function and life ability of STBI patients

作　　者：王策 蔡廷江 鹿海龙 彭文娟[2] 张文秀[2] 孙凌梅[2] WANG Ce;CAI Tingjiang;LU Hailong;PENG Wenjuan;ZHANG Wenxiu;SUN Lingmei(Department of Neurosurgery,71st Army Hospital of PLAArmy,Xuzhou,Jiangsu,221004,China;Department of Pain and Rehabilitation,71st Army Hospital of PLAArmy,Xuzhou,Jiangsu,221004,China)

机构地区：[1]中国人民解放军陆军第71集团军医院神经外科,江苏徐州221004 [2]中国人民解放军陆军第71集团军医院疼痛康复科,江苏徐州221004

出　　处：《当代医学》2021年第31期35-37,共3页Contemporary Medicine

摘　　要：目的观察改良大骨瓣减压手术对重型颅脑损伤的治疗效果及对患者认知功能和预后的影响。方法选取2017年4月至2019年4月于本院接受治疗的STBI患者为研究对象,根据手术方式分为对照组和观察组,每组40例。对照组给予常规大骨瓣减压手术,观察组给予改良大骨瓣减压手术。比较两组患者手术前后细胞因子水平、认知功能、日常生活能力。结果术前,两组患者细胞因子水平比较差异无统计学意义;术后3 d,观察组患者IL-18、IL-6、hs-CRP水平低于对照组(P<0.05)。术前,两组患者认知功能比较差异无统计学意义;术后3个月,观察组患者认知功能得分高于对照组(P<0.05)。术前,两组患者日常生活能力比较差异无统计学意义;术后3个月,观察组患者日常生活能力高于对照组(P<0.05)。结论改良大骨瓣减压手术对重型颅脑损伤的治疗效果显著,可明显改善患者的认知功能和日常生活能力,具有良好的应用价值。Objective To observe the effect of modified large bone flap decompression surgery on severe craniocerebral injury and its effect on cognitive function and prognosis.Methods The STBI patients who were treated in our hospital from April 2017 to April 2019 were selected as the research subject,and they were divided into the control group and the control group according to the operation method,with 40 cases in each group.The control group was given the standard large bone flap decompression surgery,and the observation group was given the modified large bone flap decompression surgery.The levels of cytokines,cognitive functions,and activities of daily living between the two groups of patients before and after surgery were compared in the two groups.Results There was no difference in the level of cytokines in the two groups before operation,and the levels of IL-18,IL-6 and hs-CRP in the observation group were lower than those of the control group on the 3 day after operation(P<0.05).The cognitive function of the two groups before operation was not different,and the scores of cognitive function of the patients in the observation group were higher than those in the control group at 3 months after the operation(P<0.05).Before operation,there was no statistically significant difference in the ability of daily living between the two groups of patients;after operation 3 months,the ability of daily living of the observation group was higher than that of the control group(P<0.05).Conclusion The modified large bone flap decompression surgery is better in the treatment of severe craniocerebral injury,and can obviously improve the cognitive function and daily life ability of the patients,it has good application value.

关 键 词：大骨瓣减压术 颅脑损伤 神经功能 认知功能 

分 类 号：R651.15[医药卫生—外科学]