损伤控制性外科技术治疗重型颅脑损伤合并多发伤患者的效果评价  

Evaluation of the Effect of Damage Control Surgical Techniques on Patients with Severe Craniocerebral Injury Combined with Multiple Injuries

作　　者：赵尔彬 ZHAO Erbin(Lanling People's Hospital,Lanling 277799,China)

机构地区：[1]兰陵县人民医院,山东兰陵277799

出　　处：《中外医学研究》2023年第2期154-158,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探究与分析损伤控制性外科技术治疗重型颅脑损伤合并多发伤患者的效果。方法:回顾性分析兰陵县人民医院2020年1月-2022年1月收治的109例重型颅脑损伤合并多发伤患者的临床资料,按照不同的治疗方法将其分为对照组(n=52)并实施常规治疗技术,观察组(n=57)并实施损伤控制性外科技术治疗。对比两组临床疗效、围手术期指标(入住ICU的时间、住院时间、不良反应)、治疗前后损伤严重度评分(ISS)、急性生理功能和慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、血清高移率蛋白-1(HMGB-1)、肌红蛋白(Mb)、肌酸激酶(CK)表达水平。结果:观察组临床总有效率高于对照组,差异有统计学意义(P<0.05)。观察组入住ICU的时间及住院时间均短于对照组,并发症发生率低于对照组,差异均有统计学意义(P<0.05)。治疗后,观察组ISS评分、APACHEⅡ评分、HMGB-1、Mb、CK表达水平均低于对照组,差异均有统计学意义(P<0.05)。结论:损伤控制性外科技术治疗重型颅脑损伤合并多发伤可获得更好的效果,围手术期指标表现更好,同时可调节HMGB-1、Mb、CK表达水平,促进获得更好的预后。Objective:To explore and analyze the effect of damage control surgical techniques on patients with severe craniocerebral injury combined with multiple injuries.Method:The clinical data of 109 patients with severe craniocerebral injury combined with multiple injuries who were admitted to Lanling People’s Hospital from January 2020 to January 2022 were retrospectively analyzed,and according to different treatment methods,they were divided into control group(n=52)and received routine treatment,the observation group(n=57)and received damage control surgical techniques.The clinical efficacy,perioperative indicators(ICU admission time,hospitalization time,adverse reactions),injury severity score(ISS),acute physiology and chronic health evaluation scoring systemⅡ(APACHEⅡ)score,serum high mobility group protein box-1(HMGB-1),myoglobin(Mb),creatine kinase(CK)expression levels before and after treatment were compared between the two groups.Result:The total clinical effective rate in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).The ICU admission time and hospitalization time in the observation group were shorter than those in the control group,and the incidence of complications was lower than that in the control group,the differences were statistically significant(P<0.05).After treatment,the ISS score,APACHEⅡscore,HMGB-1,Mb,CK expression levels in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion:Damage control surgical techniques can achieve better effect in the treatment of severe craniocerebral injury combined with multiple injuries,and the perioperative indicators are better.At the same time,it can regulate the expression levels of HMGB-1,Mb and CK,and promote a better prognosis.

关 键 词：损伤控制性外科技术 重型颅脑损伤 多发伤 围手术期指标 预后 

分 类 号：R651.15[医药卫生—外科学]