颅内压监测阶梯减压联合不同时机颅骨缺损修复对重型颅脑损伤病人的疗效及对其血清指标及预后的影响分析  

Analysis of the efficacy of stepwise decompression with intracranial pressure monitoring combined with different timing of skull defect repair in patients with sTBI and the effect on their serum indicators and prognosis

作　　者：袁宝玉 陆正 王东流 蔡舒 刘中平 管义祥 YUAN Baoyu;LU Zheng;WANG Dongliu(Department of Trauma Surgery,Haian People's Hospital,Jiangsu,Nantong 226600,China;不详)

机构地区：[1]江苏省海安市人民医院创伤外科,226600 [2]江苏省海安市人民医院神经外科,226600

出　　处：《临床外科杂志》2022年第12期1120-1122,共3页Journal of Clinical Surgery

基　　金：江苏省卫生健康委科研项目(Z2019033)。

摘　　要：目的探讨颅内压监测阶梯减压联合不同时机颅骨缺损修复对重型颅脑损伤(STBI)病人的疗效及对其血清指标及预后的影响。方法STBI病人73例,根据治疗方式将其分为两组,其中研究组40例,采用颅内压监测阶梯减压联合超早期颅骨缺损修复治疗,对照组33例,采用颅内压监测阶梯减压联合常规时间颅骨缺损修复治疗,比较两组病人的临床疗效,血清降钙素原及C反应蛋白的影响。结果研究组的恢复良好率高于对照组(P<0.05);研究组炎性相关检验指标均比对照组改善(P<0.05);研究组并发症发生率低于对照组,大脑中动脉(MCA)平均血流速度比对照组明显改善(P<0.05);研究组的预后优于对照组(P<0.05)。结论颅内压监测阶梯减压联合超早期颅骨缺损修复治疗重型颅脑损伤疗效显著,可减轻炎性状态并改善其脑血流灌注情况,并发症发生率降低。Objective To investigate the efficacy of stepwise decompression with intracranial pressure monitoring combined with different timing of skull defect repair in patients with sTBI and the effect on their serum indicators and prognosis.Methods Seventy-three patients with STBI who were admitted to our hospital were selected for the study.They were divided into 2 groups according to the differences in treatment modalities.Among them,40 patients in the study group were treated with intracranial pressure monitoring step decompression combined with ultra-early skull defect repair,while 33 patients in the control group were treated with intracranial pressure monitoring step decompression combined with conventional time skull defect repair,comparing the clinical efficacy and other differences between the two groups.Results After treatment,the rate of good recovery was significantly higher in the study group than in the control patients(P<0.05);All inflammation-related test indexes in the study group improved significantly after treatment compared with the control group(P<0.05);After treatment,the incidence of complications was significantly lower in the study group than in the control group(P<0.05).The mean MCA flow velocity in the study group improved significantly after treatment compared with the control group(P<0.05).After treatment,the prognosis of the study group was significantly better than that of the control patients(P<0.05).Conclusion The efficacy of intracranial pressure monitoring step decompression combined with ultra-early skull defect repair in the treatment of patients with heavy craniocerebral injury is remarkable,and it can reduce the inflammatory state of patients and improve their cerebral perfusion,and reduce the incidence of complications.

关 键 词：颅内压监测阶梯减压 超早期颅骨缺损修复 重型颅脑损伤 疗效 血清 预后 

分 类 号：R651.15[医药卫生—外科学]