改良标准外伤大骨瓣开颅手术治疗重型颅脑外伤的临床效果  

Clinical effect of modified standard large trauma craniotomy in the treatment of severe craniocerebral trauma

作　　者：宋歌[1] 杨治国 SONG Ge;YANG Zhiguo(Hanzhong People's Hospital,Hanzhong 723000,China)

机构地区：[1]汉中市人民医院,陕西汉中723000

出　　处：《临床医学研究与实践》2022年第33期83-86,共4页Clinical Research and Practice

摘　　要：目的探究改良标准外伤大骨瓣开颅手术治疗重型颅脑外伤的临床效果。方法选取2017年1月1日至2020年12月31日本院收治的60例重型颅脑外伤患者为研究对象,根据数字随机法将其分为参照组(n=30,标准大骨瓣开颅手术)和研究组(n=30,改良标准外伤大骨瓣开颅手术)。比较两组的治疗效果。结果术前,两组的美国国立卫生研究院卒中量表(NIHSS)、格拉斯哥昏迷评分量表(GCS)评分比较,差异无统计学意义(P>0.05);术后7 d,两组的NIHSS评分低于术前,GCS评分高于术前,差异具有统计学意义(P<0.05);术后7 d,研究组的NIHSS评分低于参照组,GCS评分高于参照组,差异具有统计学意义(P<0.05)。研究组的治疗总有效率高于参照组,差异具有统计学意义(P<0.05)。研究组的手术时间短于参照组,术中出血量少于参照组,差异具有统计学意义(P<0.05)。研究组的骨瓣浮出时间、骨瓣复位时间短于参照组,差异具有统计学意义(P<0.05)。研究组的并发症总发生率低于参照组,差异具有统计学意义(P<0.05)。镇静前,两组的舒张压、收缩压、心率、血氧饱和度比较,差异无统计学意义(P>0.05);镇静5、30 min时,研究组的舒张压、收缩压、心率低于参照组,差异具有统计学意义(P<0.05);镇静5、30 min时,两组的血氧饱和度比较,差异无统计学意义(P>0.05)。术前,两组的颅内压比较,差异无统计学意义(P>0.05);术后1、3、7、14 d时,研究组的颅内压低于参照组,差异具有统计学意义(P<0.05)。结论改良标准外伤大骨瓣开颅手术治疗重型颅脑外伤的效果显著,可有效改善患者的血流动力学指标,降低颅内压。Objective To explore the clinical effect of modified standard large trauma craniotomy in the treatment of severe craniocerebral trauma.Methods A total of 60 patients with severe craniocerebral trauma admitted in our hospital from January 1,2017 to December 31,2020 were selected as the research objects.The patients were divided into reference group(n=30,standard large trauma craniotomy)and study group(n=30,modified standard large trauma craniotomy)according to the digital random method.The therapeutic effects of the two groups were compared.Results Before operation,there were no significant differences in National Institutes of Health Stroke Scale(NIHSS)and Glasgow Coma Scale(GCS)scores between the two groups(P>0.05);at 7 d after operation,the NIHSS score of the two groups was lower than that before operation,the GCS score was higher than that before operation,and the differences were statistically significant(P<0.05);at7 d after operation,the NIHSS score of the study group was lower than that of the reference group,the GCS score was higher than that of the reference group,and the differences were statistically significant(P<0.05).The total effective rate of treatment in the study group was higher than that in the reference group,and the difference was statistically significant(P<0.05).The operation time of the study group was shorter than that of the reference group,the intraoperative blood loss was less than that of the reference group,and the differences were statistically significant(P<0.05).The bone flap floating time and bone flap reduction time in the study group were shorter than those in the reference group,and the differences were statistically significant(P<0.05).The total incidence of complications in the study group was lower than that in the reference group,and the difference was statistically significant(P<0.05).Before sedation,there were no significant differences in diastolic blood pressure,systolic blood pressure,heart rate and blood oxygen saturation between the two groups(P>0.05);at 5,30 min of

关 键 词：标准大骨瓣开颅手术 改良标准外伤大骨瓣开颅手术 重型颅脑外伤 

分 类 号：R651.15[医药卫生—外科学]