扩大翼点入路联合逐步控制性减压手术对重型颅脑损伤患者NIHSS评分的影响  

Effect of Extended Pterional Approach Combined with Gradually Controlled Decompression on NIHSS Scores of Severe Craniocerebral Injury Patients

作　　者：冯志铁 黄开让 冯玉璇 FENG Zhitie;HUANG Kairang;FENG Yuxuan(Neurosurgery Department,Yangjiang City People's Hospital,Yangjiang,Guangdong 529500)

机构地区：[1]阳江市人民医院神经外科,广东阳江529500

出　　处：《智慧健康》2023年第4期193-196,共4页Smart Healthcare

摘　　要：目的 分析扩大翼点入路联合逐步控制性减压手术对重型颅脑损伤患者NIHSS评分的影响。方法 选取2015年4月~2021年3月收治的140例重型颅脑损伤患者为研究对象,按照随机数字表法分为两组,每组各70例,对照组采用标准大骨瓣减压术联合传统快速减压术治疗,观察组采用扩大翼点入路联合逐步控制性减压手术治疗,对比两组术后7d NIHSS(美国国立卫生研究院卒中量表)评分和其他指标的差异。结果 与对照组对比,观察组术后24h、术后72h的颅内压更低,差异有统计学意义(P<0.05);与对照组对比,观察组术后7d时NIHSS评分更低,GCS评分更高,差异有统计学意义(P<0.05);术后6个月,与对照组对比,观察组治疗效果良好患者构成比更高,重度残疾、植物生存、死亡患者构成比更低,差异有统计学意义(P<0.05);与对照组对比,观察组术后大面积脑梗死、迟发颅内血肿、急性脑膨出等术后并发症发生率更低,差异有统计学意义(P<0.05)。结论 扩大翼点入路联合逐步控制性减压手术利于改善重型颅脑损伤患者预后,减轻神经功能缺损程度,降低颅内压,且安全性高。Objective To analyze effect of extended pterional approach combined with gradually controlled decompression on NIHSS scores of severe craniocerebral injury patients.Methods The paper chose 140 patients with severe craniocerebral injury from April 2015 to March 2021 as study objects,and divided them into two groups randomly,with 70 cases in each group.Control group was treated with standard large bone flap decompression combined with traditional rapid decompression,while observation group with expanded pterional approach combined with gradually controlled decompression,Difference in NIHSS(National Institutes of Health Stroke Scale)scores and other indicators were compared between two groups 7 days after surgery.Results Intracranial pressure in observation group was significantly lower at 24 hours and 72 hours after surgery than control group(P<0.05).Observation group had lower NIHSS scores and higher GCS scores at 7 days after surgery than control group,with statistically significant difference(P<0.05).After 6 months of surgery,observation group had higher proportion of patients with good treatment results than control group,while proportion of patients with severe disability,vegetative survival,and death was lower,with statistically significant difference(P<0.05).Incidence of postoperative complications including massive cerebral infarction,delayed intracranial hematoma,and acute encephalocele in observation group was lower than control group,with statistically significant difference(P<0.05).Conclusion Extended pterional approach combined gradually controlled decompression is beneficial for improving prognosis of patients with severe craniocerebral injury,alleviating degree of neurological deficits,and reducing intracranial pressure,which is safe and effective.

关 键 词：扩大翼点入路 逐步控制性减压手术 重型颅脑损伤 NIHSS评分 

分 类 号：R651.15[医药卫生—外科学]