阶梯减压术治疗重症颅脑创伤患者的效果及对预后的影响  

Effect of Stepwise Decompression in the Treatment of Patients with Severe Craniocerebral Trauma and Its Impact on Progsis

作　　者：张宏江[1] 张海涛 ZHANG Hongjiang;ZHANG Haitao(Department of Neurosurgery,Huaxian People's Hospital,Anyang 456400,China)

机构地区：[1]滑县人民医院神经外科,河南安阳456400

出　　处：《临床医学工程》2024年第8期979-980,共2页Clinical Medicine & Engineering

摘　　要：目的探讨颅内压(ICP)监测下的阶梯减压术治疗重症颅脑创伤患者的临床效果。方法选取2021年4月至2023年4月我院收治的100例重症颅脑创伤患者,随机分为两组各50例。观察组采用ICP监测下的阶梯减压术治疗,对照组采用去大骨瓣减压术治疗,比较两组的炎性因子、脑代谢、蛋白代谢及预后。结果术后1周,观察组的hs-CRP、TNF-α水平均低于对照组,TRE、RBP、SVO_(2)、CEO_(2)均高于对照组(P<0.05)。观察组的预后良好率为80.00%,高于对照组的56.00%(P<0.05)。结论ICP监测下的阶梯减压术可减轻重症颅脑创伤患者的炎性反应,稳定脑代谢及蛋白代谢水平,改善预后。Objective To explore the clinical effect of stepwise decompression under intracranial pressure(ICP)monitoring in the treatment of patients with severe craniocerebral trauma.Methods 100 patients with severe craniocerebral trauma admitted to our hospital from April 2021 to April 2023 were selected and randomly divided into two groups,with 50 cases in each group.The observation group was treated with stepwise decompression under ICP monitoring,and the control group was treated with large bone flap decompression.The inflammatory factors,brain metabolism,protein metabolism and prognosis were compared between the two groups.Results One week after surgery,the levels of hs-CRP and TNF-αin the observation group were lower than those in the control group,and TRE,RBP,SVO2 and CEO2 were higher than those in the control group(P<0.05).The good prognosis rate in the observation group was 80.00%,higher than 56.00%in the control group(P<0.05).Conclusions Stepwise decompression under ICP monitoring can relieve the inflammatory response of patients with severe craniocerebral trauma,stabilize the levels of brain metabolism and protein metabolism,and improve the prognosis.

关 键 词：阶梯减压术 颅内压 重症颅脑创伤 预后 

分 类 号：R651.11[医药卫生—外科学]