大骨瓣开颅减压术治疗危重颅脑外伤的临床效果  

Clinical Effect of Large Bone-Flap Decompressive Craniotomy in Treatment of Critical Craniocerebral Trauma

作　　者：苗红星 Miao Hongxing(Neurosurgery Department,Zouping People's Hospital,Zouping 256200,Shandong Province,China)

机构地区：[1]邹平市人民医院神经外科,山东邹平256200

出　　处：《中国社区医师》2024年第17期41-43,共3页Chinese Community Doctors

摘　　要：目的:分析大骨瓣开颅减压术治疗危重颅脑外伤的临床效果。方法:选取2022年6月—2023年6月邹平市人民医院收治的危重颅脑外伤患者106例作为研究对象,随机分为对照组和观察组,各53例。对照组采取常规开颅减压术治疗,观察组采取大骨瓣开颅减压术治疗。比较两组治疗效果、颅内压水平、神经功能缺损情况、昏迷状况、神经功能相关因子水平及日常生活能力。结果:观察组治疗总有效率高于对照组,差异有统计学意义(P=0.015)。术后,观察组颅内压、美国国立卫生研究院卒中量表评分,髓鞘碱性蛋白、神经元特异性烯醇化酶、胶质纤维酸性蛋白、中枢神经特异蛋白水平低于对照组,格拉斯哥昏迷指数评分、日常生活自理能力评分高于对照组,差异有统计学意义(P<0.05)。结论:大骨瓣开颅减压术治疗危重颅脑外伤的临床效果显著,能够降低患者颅内压,改善神经功能、昏迷状况及神经功能相关因子水平,提高患者日常生活能力。Objective:To analyze the clinical effect of large bone-flap decompressive craniotomy in treatment of critical craniocerebral trauma.Methods:A total of 106 patients with critical craniocerebral trauma admitted to Zouping People's Hospital from June 2022 to June 2023 were selected as the study subjects.They were randomly divided into control group and observation group,with 53 patients in each group.The control group was treated with conventional decompressive craniotomy,and the observation group was treated with large bone-flap decompressive craniotomy.The treatment effects,the level of intracranial pressure,neurological deficit,coma,the level of neurological function-related factors,and ability of daily living were compared between two groups.Results:The total response rate of treatment in the observation group was higher than that in the control group,and the difference was statistically significant(P=0.015).After surgery,the intracranial pressure,National Institutes of Health Stroke Scale score,the levels of myelin basic protein,neuron-specific enolase,glial fibrillary acidic protein and central nervous system-specific protein in the observation group were lower than those in the control group,and the scores of Glasgow Coma Scale and self-care ability in daily living in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion:Large bone-flap decompressive craniotomy in the treatment of critical craniocerebral trauma have significant clinical effects,which can reduce intracranial pressure,improve neurological function,coma and neurological function-related factor levels,and improve patients'daily living ability.

关 键 词：危重颅脑外伤 大骨瓣开颅减压术 神经功能 

分 类 号：R651.15[医药卫生—外科学]