重型颅脑损伤去骨瓣减压术加颅内压监护的临床研究  

Clinical study of decompressive craniectomy and intracranial pressure monitoring in severe craniocerebral injury

作　　者：郑海军 娄晓辉 蔡烨琰 金崇献 ZHENG Haijun;LOU Xiaohui;CAI Yeyan;JIN Chongxian(The Third Affiliated Hospital of Wenzhou Medical University,Zhejiang 325200,China)

机构地区：[1]温州医科大学附属第三医院,瑞安325200

出　　处：《浙江创伤外科》2023年第2期208-210,共3页Zhejiang Journal of Traumatic Surgery

基　　金：浙江省瑞安市2022年科技计划项目(MS2022026)。

摘　　要：目的研究颅内压监护置入及行去骨瓣减压术在重型颅脑外伤脑肿胀患者中的应用价值。方法回顾性收集本院在2018年1月至2021年12月期间收治的64例重型颅脑外伤脑肿胀患者为研究对象,根据采用的治疗方式划分为去骨瓣减压组(对照组)32例和颅内压监护置入联合去骨瓣减压组(观察组)32例,比较分析两组数据指标。结果观察组患者术后GCS评分较对照组(9.42±1.31分)高,差异显著(P<0.05);观察组术后发生消化道出血1例、肺部感染1例、肾功能损害1例和电解质紊乱1例,术后并发症发生率(12.50%)较对照组(34.38%)低,差异有统计学意义(P<0.05);观察组患者恢复良好7例,轻度残疾13例,重度残疾8例、植物生存3例和死亡1例,预后显著优于对照组,差异有统计学意义(P<0.05)。结论颅内压监护探头置入及去骨瓣减压术在重型颅脑外伤脑肿胀患者的治疗中临床效果良好,减少术后并发症的同时明显改善了患者预后,为此类患者的诊治提供了临床新思路。Objective To study the value of intracranial pressure monitoring implantation and decompressive craniectomy in patients with brain swelling after severe head injury.Methods 64 patients with severe brain trauma and brain swelling treated in our department from January 2018 to December 2021 were retrospectively collected as the research objects.According to the treatment methods adopted,32 patients were divided into the decompressive craniectomy group(control group).32 patients were divided into the decompressive craniectomy and intracranial pressure monitoring implantation group(observation group).The data indicators of the two groups were compared and analyzed.Results The GCS score in the observation group was significantly higher than that in the control group(P<0.05).The incidence of postoperative complications in the observation group(12.50%)was lower than that in the control group(34.38%)(P<0.05).The patients in the observation group recovered well in 7 cases,mild disability in 13 cases,severe disability in 8 cases,vegetative survival in 3 cases and death in 1 case,and the prognosis was significantly better than that in the control group(P<0.05).Conclusion Intracranial pressure monitoring probe implantation and decompressive craniectomy have a good clinical effect in the treatment of severe brain trauma patients with brain swelling.It can reduce postoperative complications and significantly improve the prognosis of patients,providing a new clinical idea for the diagnosis and treatment of severe craniocerebral injury.

关 键 词：重型颅脑损伤 弥漫性脑肿胀 骨瓣减压术 颅内压监护置入 

分 类 号：R651.1[医药卫生—外科学]