双侧去骨瓣减压开颅手术治疗重型对冲性颅脑外伤的效果及对脑氧代谢指标的影响  

Effect of Bilateral Remove Bone Flap Decompressive Craniotomy in the Treatment of Severe Contralateral Traumatic Brain Injury and Its Influence on Cerebral Oxygen Metabolism Index

作　　者：胡方进 周小菊 周建军 张明亮 郭东斌 邱平 HU Fangjin;ZHOU Xiaoju;ZHOU Jianjun;ZHANG Mingliang;GUO Dongbin;QIU Ping(Longyan First Hospital Affiliated to Fujian Medical University,Longyan 364000,China;不详)

机构地区：[1]福建医科大学附属龙岩第一医院,福建龙岩364000

出　　处：《中外医学研究》2024年第2期14-17,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨双侧去骨瓣减压开颅手术治疗重型对冲性颅脑外伤的效果及对脑氧代谢指标的影响。方法:选取2020年1月—2023年1月福建医科大学附属龙岩第一医院收治的60例重型对冲性颅脑外伤患者。根据抽签法将其分为对照组和观察组,各30例。对照组给予标准大骨瓣开颅减压术,观察组给予双侧去骨瓣减压开颅手术。比较两组手术疗效、神经功能、脑氧代谢指标、炎症因子及并发症。结果:术后2周,观察组总有效率高于对照组,差异有统计学意义(P<0.05)。术后2周,两组美国国立卫生研究院卒中量表(NIHSS)评分降低,观察组NIHSS评分低于对照组,术后3 d,两组神经元特异性烯醇化酶(NSE)水平降低,静脉血氧饱和度(SvO2)水平升高,观察组NSE水平低于对照组,SvO2水平高于对照组,差异有统计学意义(P<0.05)。术前及术后3 d,两组白细胞介素-2(IL-2)、白细胞介素-4(IL-4)水平比较,差异无统计学意义(P>0.05);术后3 d,两组IL-2水平降低,IL-4水平升高,差异有统计学意义(P<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:双侧去骨瓣减压开颅手术治疗重型对冲性颅脑外伤患者的效果更好,可减轻神经功能损伤,改善患者脑氧代谢情况,并发症少。Objective:To investigate the effect of bilateral remove bone flap decompressive craniotomy in the treatment of severe contralateral traumatic brain injury and its influence on cerebral oxygen metabolism index.Method:A total of 60 patients with severe contralateral traumatic brain injury admitted to Longyan First Hospital Affiliated to Fujian Medical University from January 2020 to January 2023 were selected.They were divided into control group and observation group according to the lottery method,with 30 cases in each group.The control group was given standard large bone flap decompressive craniotomy,and the observation group was given bilateral remove bone flap decompressive craniotomy.The operative effect,nerve function,cerebral oxygen metabolism indexes,inflammatory factors and complications were compared between the two groups.Result:At 2 weeks after surgery,the total effective rate of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05).At 2 weeks after surgery,the National Institutes of Health stroke scale(NIHSS)score of both groups decreased,and the NIHSS score of the observation group was lower than that of the control group,3 d after surgery,the level of neuron-specific enolase(NSE)in both groups decreased,the level of venous oxygen saturation(SvO2)increased,and the NSE level in the observation group was lower than that in the control group,and the SvO2 level was higher than that in the control group,and the differences were statistically significant(P<0.05).There were no significant differences in the levels of interleukin-2(IL-2)and interleukin-4(IL-4)between the two groups before and 3 d after surgery(P>0.05).At 3 d after surgery,the level of IL-2 decreased and the level of IL-4 increased in the two groups,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:Bilateral remove bone flap decompressive craniotomy

关 键 词：双侧去骨瓣减压开颅手术 重型对冲性颅脑外伤 神经功能 脑氧代谢 并发症 

分 类 号：R651.15[医药卫生—外科学]