改良大骨瓣开颅减压术治疗重症对冲性颅脑损伤患者的效果  

Effect of Modified Large Bone Flap Craniotomy Decompression in the Treatment of Patients with Severe Traumatic Brain Injury

作　　者：杨燕煌 陈文彬 游清龙 YANG Yanhuang;CHEN Wenbin;YOU Qinglong(Zhangzhou Second Hospital,Zhangzhou 363102,China;不详)

机构地区：[1]漳州市第二医院,福建漳州363102

出　　处：《中外医学研究》2023年第29期17-20,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:观察比较改良大骨瓣开颅减压术与传统标准大骨瓣开颅减压术治疗重症对冲性颅脑损伤(STBI)患者的效果。方法:回顾性分析2019年1月—2021年1月漳州市第二医院收治的85例STBI患者的资料,根据患者实施手术方案的不同分两组,其中对照组(n=41)接受标准大骨瓣开颅减压术治疗,改良组(n=44)接受改良大骨瓣开颅减压术治疗。比较两组术后相关指标(术后中线移位、血肿厚度及不同时间内的颅内压水平)、临床治疗效果、围手术期并发症发生情况。结果:改良组术后中线移位、血肿厚度及术后1 d、3 d、5 d的颅内压水平均显著低于对照组,差异有统计学意义(P<0.05)。改良组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。改良组围手术期并发症总发生率明显低于对照组,差异有统计学意义(P<0.05)。结论:STBI患者选择改良大骨瓣开颅减压术可以更好地降低术后中线移位、血肿厚度及不同时间内的颅内压水平,提升治疗总有效率,减少术后相关并发症的发生。Objective:To observe and compare the effect of modified large bone flap craniotomy decompression and standard large bone flap craniotomy decompression in the treatment of patients with severe traumatic brain injury(STBI).Method:Retrospective analysis of the data of 85 patients with STBI admitted to Zhangzhou Second Hospital from January 2019 to January 2021.The patients were divided into two groups according to different surgical protocols.The control group(n=41)received standard large bone flap craniotomy decompression,while the improved group(n=44)received modified large bone flap craniotomy decompression.The relevant postoperative indexes(postoperative midline displacement,hematoma thickness and intracranial pressure level at different time),clinical treatment effect and perioperative complications were compared between the two groups.Result:Postoperative midline displacement,hematoma thickness and intracranial pressure levels at 1 d,3 d and 5 d after operation in the improved group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).The total effective rate of the improved group was higher than that of the control group,and the difference was statistically significant(P<0.05).The total incidence of perioperative complications in the improved group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:The selection of modified large bone flap craniotomy decompression for STBI patients can better reduce postoperative midline displacement,hematoma thickness and intracranial pressure levels at different times,improve the total effective rate of treatment,and reduce the occurrence of postoperative complications.

关 键 词：改良手术 传统标准手术方案 重症对冲性颅脑损伤 颅内压 治疗效果 

分 类 号：R651.15[医药卫生—外科学]