重型颅脑创伤患者行控制性阶梯式颅内减压手术治疗的效果分析  

Effect analysis of controlled stepwise intracranial decompression in patients with severe traumatic brain injury

作　　者：叶益军 杨捷[1] 梁鄂 Ye Yijun;Yang Jie;Liang E(Neurosurgery Department,Fujian Jianou Hospital,Jianou 353100)

机构地区：[1]福建省建瓯市立医院神经外科,建瓯353100

出　　处：《数理医药学杂志》2022年第11期1616-1619,共4页Journal of Mathematical Medicine

摘　　要：目的:将手术治疗应用于重型颅脑创伤患者,术中颅内减压采用阶梯式,探讨此方法的治疗效果。方法:本次研究患者来自于2020年7月—2022年6月期间我院的治疗病例,纳入了64例重型颅脑伤患者,基于不同的手术方式加以分组,每组人数均等。对照组给予常规式的减压术治疗,改良组颅内减压手术加强了控制,采用了阶梯式治疗。对比两组患者的手术效果。结果:改良组术中出血量、甘露醇用量均要少于对照组,手术持续时间要短于对照组(均P<0.05);治疗前,对比两组GOS评分、GCS评分、NIHSS评分、Barthel评分、脑血氧饱和度与动脉血氧分压,差异不明显(P>0.05);治疗后,改良组上述指标的改善效果均优于对照组(均P<0.05);改良组恢复良好的比例(56.88%)要高于对照组的25.00%,P<0.05;改良组死亡率(6.25%)要低于对照组(15.63%),P<0.05;改良组并发症发生率为21.8%,低于对照组的6.25%(P<0.05)。结论:对于重型颅脑损伤的治疗,手术中要注意压力,采用阶梯式颅内减压疗效明显,有利改善预后,体现出推广价值。Objective: To investigate the therapeutic effect of surgical treatment in patients with severe traumatic brain injury. Methods: This study included 64 patients with severe craniocerebral injury who were treated in our hospital from July 2020 to June 2022. They were divided into groups based on different surgical methods, and the number of patients in each group was equal. The control group was treated with conventional decompression surgery, while the modified group was treated with step-based treatment. The surgical effects of the two groups were compared. Results:The amount of blood loss and the amount of mannitol in the modified group were less than those in the control group, and the operation duration was shorter than that in the control group(all P<0.05). Before treatment, there were no significant differences in GOS score, GCS score, NIHSS score, Barthel score, cerebral oxygen saturation and arterial oxygen partial pressure between the two groups(P>0.05). After treatment, the improvement effect of the above indexes in the observation group was better than that in the control group(all P<0.05). The proportion of good recovery in the improved group(56.88%) was higher than that in the control group(25.00%), P<0.05;The mortality rate of modified group(6.25%)was lower than that of control group(15.63%), P<0.05;The complication rate of modified group was 21.8%, which was lower than 6.25% of control group(P<0.05). Conclusion: For patients with severe craniocerebral injury, paying attention to the pressure during operation, using the step intracranial decompression has obvious curative effect, can improve the prognosis, and embodies the value of promotion.

关 键 词：重型颅脑创伤 手术治疗 阶梯式减压 减压控制 手术疗效 

分 类 号：R641[医药卫生—外科学]