分步控制性减压术治疗重型脑外伤的临床效果  

Clinical effect of step-by-step controlled decompression in the treatment of severe traumatic brain injury

作　　者：姜志远[1] JIANG Zhiyuan(Department of Neurosurgery,Affiliated Hospital of Xiangnan University,Hu′nan Province,Chenzhou423000,China)

机构地区：[1]湘南学院附属医院神经外科,湖南郴州423000

出　　处：《中国当代医药》2022年第1期104-107,共4页China Modern Medicine

摘　　要：目的探讨分步控制性减压术治疗重型脑外伤的临床效果。方法选取2019年1月至2020年12月湘南学院附属医院接收的140例重型脑外伤患者作为研究对象,采用随机数字表法将其分为对照组和观察组,每组各70例。对照组患者采用开颅血肿清除及骨瓣减压术治疗,观察组患者采用分步控制性减压术治疗。比较两组患者的日常生活能力改善情况、不良反应总发生率以及神经功能恢复情况。结果两组患者的术中出血量、术后住院时间、手术时间比较,差异无统计学意义(P>0.05);治疗前,两组患者的各项自主生活能力评分比较,差异无统计学意义(P>0.05);观察组患者治疗后的进食、如厕、平地行走、床椅转移等自主生活能力评分及总分均高于对照组,差异有统计学意义(P<0.05);观察组患者治疗后的并发症总发生率低于对照组,差异有统计学意义(P<0.05);治疗前,两组患者的美国国立卫生研究院卒中量表(NIHSS)评分、日常生活活动能力Barthel指数比较,差异无统计学意义(P>0.05);观察组患者治疗后的NIHSS评分低于对照组,差异有统计学意义(P<0.05);观察组患者治疗后的Barthel指数高于对照组,差异有统计学意义(P<0.05)。结论重型脑外伤治疗中应用分步控制性减压术,可以显著改善患者的术后日常自主生活能力,恢复患者的神经功能,减少不良反应的发生。Objective To investigate the clinical effect of step-by-step controlled decompression in the treatment of severe traumatic brain injury.Methods A total of 140 patients with severe traumatic brain injury admitted into the Affiliated Hospital of Xiangnan University from January 2019 to December 2020 were selected as the research subjects.They were divided into a control group and an observation group by random number table method,70 cases in each group.The patients in the control group were treated with craniotomy hematoma removal and bone flap decompression,and patients in the observation group were treated with step-by-step controlled decompression.The improvement of daily living ability,the total incidence of adverse reactions and the recovery of neurological function were compared between the two groups.Results There were no significant differences in intraoperative blood loss,postoperative hospital stay and operation time between the two groups(P>0.05).Before treatment,there were no significant differences in the scores of independent living ability between the two groups(P>0.05).The scores of eating,toilet,flat walking,bed and chair transfer and other independent living ability and total scores of patients in the observation group were higher than those in the control group after treatment,with statistically significant differences(P<0.05).The total incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Before treatment,there were no significant differences in National Institutes of Health stroke scale(NIHSS)score and Barthel index of activities of daily living between the two groups(P>0.05).NIHSS score of observation group was lower than that in the control group after treatment,the difference was statistically significant(P<0.05).The Barthel index of the observation group was higher than that of the control group after treatment,the difference was statistically significant(P<0.05).Conclusion The application of step-by

关 键 词：分步控制性减压术 重型 脑外伤 临床疗效 对照试验 

分 类 号：R651.15[医药卫生—外科学]