颧弓上耳屏边缘小切口去大骨瓣减压术对重度颅脑损伤患者的疗效  

Curative Effect of Small Incision Decompressive Craniectomy at the Upper Tragus Border of the Zygomatic Arch in Patients with Severe Craniocerebral Injury

作　　者：陈红政 CHEN Hongzheng(Department of Neurosurgery,Fengqiu People’s Hospital,Xinxiang 453300,China)

机构地区：[1]封丘县人民医院神经外科,河南新乡453300

出　　处：《河南医学研究》2022年第14期2561-2564,共4页Henan Medical Research

摘　　要：目的分析颧弓上耳屏边缘小切口去大骨瓣减压术治疗重度颅脑损伤(STBI)患者的效果。方法回顾性选取2018年10月至2020年2月封丘县人民医院收治的88例STBI患者,依照手术方案分为对照组和观察组,对照组(42例)接受标准去大骨瓣减压术,观察组(46例)接受颧弓上耳屏边缘小切口去大骨瓣减压术,比较两组治疗效果。结果术后6个月,两组临床治疗效果比较,差异无统计学意义(P>0.05);术后1、3、5 d,两组颅内压均降低,且观察组较对照组低(P<0.05);术后7 d,两组血清降钙素原(PCT)、白细胞介素-2(IL-2)、肿瘤坏死因子-α(TNF-α)水平均升高,观察组PCT、IL-2、TNF-α水平低于对照组(P<0.05);术后6个月,两组Fugl-Meyer运动功能测评法(FMA)、认知功能评定表(LOTCA)评分均升高,且观察组较对照组高(P<0.05);观察组并发症发生率(6.52%)较对照组(30.95%)低(P<0.05)。结论颧弓上耳屏边缘小切口去大骨瓣减压术治疗STBI可降低患者颅内压,改善患者运动、认知功能,对炎症因子水平影响小,且安全性高。Objective To analyze the curative effect of small incision decompressive craniectomy at the upper tragus border of the zygomatic arch in the treatment of patients with severe traumatic brain injury(STBI).Methods A total of 88 STBI patients who were treated in Fengqiu People’s Hospital from October 2018 to February 2020 were retrospectively selected and divided into observation group and control group according to surgical plans.The control group(42 cases)received standard decompressive craniectomy,and the observation group(46 cases)received small incision decompressive craniectomy at the upper tragus border of the zygomatic arch.The therapeutic effects of the two groups were compared.Results Six months after operation,there was no statistical difference in the clinical treatment effect between the two groups(P>0.05).1,3 and 5 days after operation,the intracranial pressure in both groups decreased,and the observation group were lower than those in the control group(P<0.05).7 days after operation,the levels of serum procalcitonin(PCT),interleukin-2(IL-2),tumor necrosis factor-α(TNF-α)in the two groups were increased,while the levels of PCT,IL-2 and TNF-αin the observation group were lower than those in the control group(P<0.05).6 months after operation,the Fugl-Meyer motor function assessment(FMA)scores and loewenstein occupational therapy cognitive assessment(LOTCA)in both groups were increased,and the scores in the observation group were higher than those in the control group(P<0.05).The incidence of complications in the observation group(6.52%)was lower than that(30.95%)in the control group(P<0.05).Conclusion Small incision decompressive craniectomy at the upper tragus border of the zygomatic arch can reduce the intracranial pressure of STBI patients,improve patients’motor and cognitive function,has little effect on the level of inflammatory factors,and with high safety.

关 键 词：重度颅脑损伤 颧弓上耳屏边缘小切口 去大骨瓣减压术 颅内压 

分 类 号：R651.11[医药卫生—外科学]