脑外伤急诊开颅术对颅脑外伤患者脑血管血液动力学研究  

Effect of Emergency Craniotomy on Cerebrovascular Hemodynamics in Patients with Traumatic Brain Injury

作　　者：铁江辉 马琳 Tie Jiang-hui;Ma Lin(Neurosurgery Department of Gongyi People's Hospital,Gongyi 451200,Henan Province,China)

机构地区：[1]巩义市人民医院神经外科,河南巩义451200

出　　处：《罕少疾病杂志》2023年第9期26-28,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的 探讨脑外伤急诊开颅术对颅脑外伤患者脑血管血液动力学影响。方法 选取我院2018年6月到2020年6月急诊共收治的115例颅脑外伤患者,根据手术方法将患者分为两组,给予对照组传统开颅去骨瓣减压手术,给予观察组患者双侧开颅手术,对比不同手术方法对患者的治疗效果,平均血流速度和收缩期峰流速的影响,颅内压和GCS评分,并对比两组患者术后并发症发生情况。结果 对照组治疗总有效率为73.67%,观察组治疗总有效率为89.66%,观察组显著高于对照组(P<0.05);两组手术前平均血流速度和收缩期峰流速对比无差异(P>0.05),术后7 d观察组平均血流速度和收缩期峰流速明显高于对照组(P<0.05);两组手术前颅内压和GCS评分对比无明显差异(P>0.05),手术7 d后观察组的颅内压明显低于对照组(P<0.05),观察组的GCS评分明显高于对照组(P<0.05);观察组的并发症发生率为6.9 0%,对照组的并发症发生率为22.81%,观察组明显低于对照组(P<0.05)。结论 针对脑外伤急诊开颅术患者应用双侧开颅手术能够提升患者的治疗效果,减少死亡率,稳定患者脑血管血液动力学指标,减少患者意识障碍现象,减轻颅内压,安全性好。Objective To investigate the effect of emergency craniotomy on cerebrovascular hemodynamics in patients with traumatic brain injury.Methods A total of 115 cases of traumatic brain injury in our hospital from June 2018 to June 2020,and the patients were divided into two groups according to the surgical method.The control group was given traditional craniotomy decompressive surgery,and the observation group was given bilateral craniotomy.The therapeutic effect of different surgical methods on patients,average blood flow velocity and peak systolic velocity were compared influence,intracranial pressure and GCS score,and compared the incidence of postoperative complications between the two groups.Results The total effective rate of the control group was 73.67%,and that of the observation group was 89.66%,which was significantly higher than that of the control group(P<0.05).There was no difference in the average blood flow velocity and peak systolic velocity between the two groups before surgery(P>0.05).The average blood flow velocity and peak systolic velocity in the observation group were significantly higher than those in the control group at 7 days postoperatively(P<0.05).There was no significant difference between the intracranial pressure and GCS score before surgery(P>0.05).7 days after the operation,the intracranial pressure of the observation group was significantly lower than that of the control group(P<0.05),and the GCS score of the observation group was significantly higher than that of the control group(P<0.05).The complication rate of the observation group was 6.90%,which was significantly lower than that of the control group(22.81%,P<0.05).Conclusion The application of bilateral craniotomy in patients with brain trauma emergency craniotomy can improve the treatment effect of patients,reduce mortality,stabilize the cerebrovascular hemodynamic indexes,reduce the disturbance of consciousness and intracranial pressure,which is worthy of clinical application and promotion.

关 键 词：脑外伤急诊 开颅术 脑血管血液动力学 脑外伤 

分 类 号：R651.15[医药卫生—外科学]