开颅术前硬通道硬膜下穿刺预减压对创伤性急性硬膜下血肿合并脑疝患者疗效的影响  

Effect of Pre-decompression by Hard Channel Subdural Puncture before Craniotomy on the Curative Effect of Traumatic Acute Subdural Hematoma Complicated with Brain Herniation

作　　者：黄燕钦 HUANG Yanqin(Puning Overseas Chinese Hospital,Guangdong Province,Puning 515300,China)

机构地区：[1]广东省揭阳市普宁华侨医院,广东普宁515300

出　　处：《中国医学创新》2022年第29期26-29,共4页Medical Innovation of China

基　　金：揭阳市科技计划项目(210629102351014)。

摘　　要：目的:分析开颅术前硬通道硬膜下穿刺预减压对创伤性急性硬膜下血肿合并脑疝患者疗效的影响。方法:回顾性分析2020年1月-2022年1月普宁华侨医院收治的80例创伤性急性硬膜下血肿合并脑疝患者的临床资料,依据治疗方案分为两组,各40例。对照组采取开颅术治疗,观察组开颅术前实施硬通道硬膜下穿刺预减压治疗。比较两组颅内压、预后、恶性脑膨出发生率和生存质量评分。结果:术前,两组颅内压比较,差异无统计学意义(P>0.05);术后1、7 d,两组颅内压均低于术前,且观察组均低于对照组,差异均有统计学意义(P<0.05)。观察组恢复良好率高于对照组,轻度残疾率、重度残疾率、恶性脑膨出发生率均低于对照组,差异均有统计学意义(P<0.05)。术后7 d,观察组生理机能、生理职能、躯体疼痛、一般健康状况、精力、社会功能、情感职能、精神健康评分均高于对照组,差异均有统计学意义(P<0.05)。结论:开颅术前硬通道硬膜下穿刺预减压能够改善创伤性急性硬膜下血肿合并脑疝患者预后,降低颅内压水平并预防恶性脑膨出的发生,进一步改善患者生存质量,值得推广使用。Objective:To analyze the effect of pre-decompression by hard channel subdural puncture before craniotomy on the curative effect of traumatic acute subdural hematoma complicated with brain herniation.Method:The clinical data of 80 patients with traumatic acute subdural hematoma complicated with brain herniation who were admitted to Puning Overseas Chinese Hospital from January 2020 to January 2022 were retrospectively analyzed,according to the treatment plan,they were divided into two groups,with 40 cases in each group.The control group was treated with craniotomy,and the observation group was treated with pre-decompression by hard channel subdural puncture before craniotomy.The intracranial pressure,prognosis,incidence of malignant encephalocele and quality of life scores were compared between the two groups.Result:Before operation,there was no significant difference in intracranial pressure between the two groups(P>0.05);1 and 7 d after operation,the intracranial pressure of both groups were lower than those before operation,and those in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).The rate of good recovery in the observation group was higher than that in the control group,and the rate of mild disability,severe disability and malignant encephalocele in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).7 d after operation,the scores of physiological function,physiological function,body pain,general health status,energy,social function,emotional function and mental health in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).Conclusion:Pre-decompression by hard channel subdural puncture before craniotomy can improve the prognosis of patients with traumatic acute subdural hematoma complicated with brain herniation,reduce the level of intracranial pressure,prevent the occurrence of malignant encephalocele

关 键 词：创伤性急性硬膜下血肿 脑疝 开颅术 硬通道硬膜下穿刺预减压 预后 

分 类 号：R651.15[医药卫生—外科学]