标准大骨瓣开颅减压术对重型颅脑损伤的治疗效果分析  

Effect of Standard Large Craniotomy Decompression on Severe Craniocerebral Injury

作　　者：陈盾渊 韩明对 CHEN Dun-yuan;HAN Ming-dui(Emergency Department,The Second Afiliated Hospital of Shantou University Medical College,Guangdong,Shantou 515041,China)

机构地区：[1]汕头大学医学院第二附属医院急诊科,汕头515041

出　　处：《伤害医学（电子版）》2023年第2期40-45,共6页Injury Medicine(Electronic Edition)

摘　　要：目的探究标准大骨瓣开颅减压术对重型颅脑损伤的治疗效果。方法回顾性选取2021年3月至2022年3月某院收治的98例重型颅脑损伤患者为研究对象,50例采用标准大骨瓣开颅减压术治疗的患者为研究组,48例采用常规骨瓣开颅减压术治疗的患者为对照组。比较两组的疗效、术后并发症、颅内压、卒中评分(National Institute of Health stroke scale,NISS)、格拉斯哥昏迷评分(glasgow coma scale,GCS)、神经功能。结果研究组的生存率高于对照组,术后并发症总发生率低于对照组(P<0.05);两组术后3 d、7 d的颅内压、术后1周的NISS评分、胶质纤维酸性蛋白(glial fibrillary acidic protein,GFAP)均低于术前,且研究组低于对照组(P<0.05);两组术后1周的GCS评分、神经生长因子(nerve growth factor,NGF)均高于术前,且研究组高于对照组(P<0.05)。结论对于治疗重型颅脑损伤,标准大骨瓣开颅减压术相较常规骨瓣开颅减压术其疗效更佳,能有效提高患者神经功能、生存率及生存质量,降低颅内压,减少患者术后并发症。Objective To explore the effect of standard large craniotomy decompression on severe craniocerebral injury.Methods From March 2021 to March 2022,98 patients with severe craniocerebral injury who were treated in the Second Affiliated Hospital were retrospectively selected as the study objects.Among them,50 patients treated with standard large craniotomy decompression were divided into the study group,and 48 patients treated with conventional craniotomy decompression as the control group.The efficacy,postoperative complications,intracranial pressure,NISS score(National Institute of Health stroke scale),Glasgow coma scale(GCS)score and neurological function were compared between the two groups.Results The survival rate of the study group was significantly higher than that of the control group(P<0.05).The intracranial pressure,NISS score and glial fibrillary acidic protein(GFAP)at 3 and 7 days after surgery were lower in two groups than before surgery,and the study group was lower than the control group(P<0.05).The GCS scores and the nerve growth factor(NGF)of the two groups were higher than those before surgery,and the study group was higher than the control group(P<0.05).Conclusions Standard large craniotomy decompression was more effective than the conventional craniotomy in the treatment of severe craniocerebral injury.The better application effectively improved the neurological function,survival rate and quality of life of patients,reduce intracranial pressure and reduce postoperative complications.

关 键 词：标准大骨瓣开颅减压术 重型颅脑损伤 临床疗效 

分 类 号：R651.15[医药卫生—外科学]