标准外伤大骨瓣开颅去骨瓣减压术治疗重型颅脑损伤的效果及安全性  

Efficacy and Safety of Standard Traumatic Large Bone Flap Craniotomy and Decompressive Craniotomy in Patients with Severe Craniocerebral Injury

作　　者：张辉 杨西安[1] 胡怡勇[1] ZHANG Hui;YANG Xi’an;HU Yiyong(Macheng People's Hospital,Macheng 438300,China;不详)

机构地区：[1]麻城市人民医院,湖北麻城438300

出　　处：《中外医学研究》2023年第35期154-157,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:基于临床数据分析标准外伤大骨瓣开颅去骨瓣减压术治疗重型颅脑损伤的效果及安全性。方法:选取2022年1—12月麻城市人民医院神经外科收治的64例重型颅脑损伤患者为研究对象,根据不同的治疗方法分组,对照组32例,采用冠状骨瓣开颅去骨瓣减压术;观察组32例,采用标准外伤大骨瓣开颅去骨瓣减压术。对比两组的颅内压、脑氧代谢指标、格拉斯哥昏迷量表(GCS)评分、并发症发生情况。结果:观察组术后1 d、3 d、5 d颅内压均低于对照组,差异有统计学意义(P<0.05)。术后1 d,观察组颈内静脉血氧含量(CjvO_(2))、动脉血氧含量(CaO_(2))高于对照组,桡动脉-颈内静脉球部血氧含量差(Da-jvO_(2))低于对照组,差异有统计学意义(P<0.05)。观察组术后1 d、3 d、5 d GCS评分高于对照组,差异有统计学意义(P<0.05)。观察组硬膜下积液、多器官功能衰竭、再出血、感染等并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:重型颅脑损伤患者采用标准外伤大骨瓣开颅去骨瓣减压术治疗,较冠状骨瓣开颅去骨瓣减压术具有更好的治疗效果和安全性。Objective:To analyze the efficacy and safety of standard traumatic large bone flap craniotomy and decompressive craniotomy for severe craniocerebral injury based on clinical data.Method:A total of 64 patients with severe craniocerebral injury admitted to the Department of Neurosurgery of Macheng People's Hospital from January to December 2022 were selected as the study objects.They were divided into groups according to different treatment methods.Totally 32 patients in the control group were treated with coronary craniotomy and decompressive craniotomy.In the observation group,32 cases were treated with standard traumatic large bone flap craniotomy and decompressive craniotomy.Intracranial pressure,cerebral oxygen metabolism,Glasgow coma scale(GCS)score and complications were compared between the two groups.Result:The intracranial pressure in the observation group were lower than those in the control group on 1 d,3 d and 5 d after operation,and the differences were statistically significant(P<0.05).On 1 d after operation,oxygen content of internal jugular vein(CjvO_(2)),arterial oxygen content(CaO_(2))in the observation group were higher than those in the control group,and arterial to jugular bulbar blood oxygen difference(Da-jvO_(2))was lower than that in the control group,the differences were statistically significant(P<0.05).The GCS scores of the observation group were higher than those of the control group on 1 d,3 d and 5 d after operation,and the differences were statistically significant(P<0.05).The incidence of complications such as subdural effusion,multiple organ failure,rebleeding and infection in observation group was lower than that in control group,and the difference was statistically significant(P<0.05).Conclusion:Standard traumatic large bone flap craniotomy and decompressive craniotomy for patients with severe craniocerebral injury has better efficacy and safety than coronary craniotomy and decompressive craniotomy.

关 键 词：重型颅脑损伤 手术方法 标准外伤大骨瓣开颅去骨瓣减压术 治疗效果 安全性 

分 类 号：R651.15[医药卫生—外科学]