标准去骨瓣减压术联合LCFD治疗重型颅脑损伤伴SAH的临床效果及预后观察  

Clinical Results and Prognosis of Standard Bone Flap Decompression Combined with LCFD for Severe Craniocerebral Injury with Subarachnoid

作　　者：胡要锋 马腾飞 胡艺博 Hu Yaofeng;Ma Tengfei;Hu Yibo(Neurosurgery Department,Ruzhou People’s Hospital,Ruzhou,Henan,467500,China)

机构地区：[1]汝州市人民医院神经外科,河南汝州467500

出　　处：《黑龙江医学》2024年第19期2360-2362,共3页Heilongjiang Medical Journal

摘　　要：目的:分析标准去骨瓣减压术联合持续腰大池引流术(LCFD)治疗重型颅脑损伤伴蛛网膜下腔出血(SAH)的治疗效果。方法:选取2021年7月—2022年7月汝州市人民医院神经外科收治的70例重型颅脑损伤合并SAH患者作为研究对象,根据入院先后顺序分为对照组(35例)与研究组(35例),分别进行标准去骨瓣减压术与标准去骨瓣减压术联合LCFD治疗。对比观察两组患者治疗后7 d临床效果、临床指标以及预后数据变化差异情况。结果:研究组患者临床治疗有效率(91.43%)显著高于对照组(71.43%),差异有统计学意义(χ^(2)=4.629,P<0.05);对比观察两组患者临床疗效发现,研究组术后颅内压、脑脊液因子、脑代谢水平得到显著改善,差异均有统计学意义(t=8.490、3.788、6.524、5.518,P<0.05);使用格拉斯哥预后评分(GOS)评估观察两组患者预后发现,研究组术后预后良好,差异有统计学意义(χ^(2)=5.040,P<0.05)。结论:重型颅脑损伤合并SAH病症对患者预后及神经功能影响较大,采取标准去骨瓣减压术联合LCFD治疗疾病,能有效提高患者整体治疗效果,对于改善患者预后具有积极意义。Objective:To analyze the therapeutic effect of standard bone flap decompression combined with continuous lumbar large pool drainage(LCFD)in severe craniocerebral injury with subarachnoid hemorrhage(SAH).Methods:70 patients with severe craniocerebral injury complicated with SAH admitted to Neurosurgery Department,Ruzhou People’s Hospital from July 2021 to July 2022 were selected as the study subjects.According to the order of admission,they were divided into control group and study group,and standard decompressive craniotomy and standard decompressive craniotomy combined with LCFD surgery were performed respectively.The clinical effect,clinical indexes and prognostic data of the two groups were compared and observed 7 days after treatment.Results:The clinical treatment effective rate of 91.43%in the study group was significantly higher than 71.43%in the control group,and there was statistically significant difference between the groups(χ^(2)=4.629,P<0.05).Through comparing the clinical efficacy of the two groups,it was found that the intracranial pressure,cerebrospinal fluid factor and brain metabolism level in the study group were significantly improved,and the differences were statistically significant(t=8.490,3.788,6.524,5.518;P<0.05).GOS scale score was used to observe the prognosis of the two groups of patients.It was found that the postoperative prognosis of the study group was good,and the difference was statistically significant(χ^(2)=5.040,P<0.05).Conclusion:Severe craniocerebral injury with SAH has great impact on the prognosis and neurological function of patients.The standard bone flap decompression combined with LCFD surgery to treat the disease can effectively improve the overall treatment effect of patients,have positive significance for improving the prognosis of patients.It has high clinical application value.

关 键 词：重型颅脑损伤 蛛网膜下腔出血 标准去骨瓣减压术 持续腰大池引流术 

分 类 号：R651.15[医药卫生—外科学]