充分减压法在重型颅脑创伤手术治疗中的效果  

Effect of sufficient decompression method in the surgical treatment of severe brain injury

作　　者：马洪鑫[1] 戚贵军[1] 卢璐祥 MA Hong-xin;QI Gui-jun;LU Lu-xiang(Department of Neurosurgery,Tengzhou Central People's Hospital,Tengzhou Shandong Province 277599,China)

机构地区：[1]滕州市中心人民医院神经外科,山东滕州277599

出　　处：《中国城乡企业卫生》2024年第9期25-27,共3页Chinese Journal of Urban and Rural Enterprise Hygiene

摘　　要：目的探讨充分减压法在重型颅脑创伤手术治疗中的应用效果,探究重型颅脑创伤安全可靠的手术方式。方法选取2021年6月—2022年6月在山东省济宁医学院附属滕州市中心人民医院进行手术治疗的60例重型颅脑创伤患者,以电脑随机法分为对照组和观察组各30例。对照组行标准大骨瓣开颅术治疗,观察组行充分减压法开颅术治疗。比较两组患者的颅内压水平、格拉斯哥预后量表(GOS)评分、美国国立卫生研究院卒中量表(NIHSS)评分及Barthel指数评分。结果手术前,两组颅内压水平比较差异无统计学意义(P>0.05);术后即刻、3 d及7 d,观察组颅内压水平为(22.58±3.72)、(15.11±5.33)及(14.28±4.83)mmHg,低于对照组的(27.72±3.65)、(23.01±6.47)及(19.41±5.06)mmHg,差异均有统计学意义(t=4.351、5.161、4.015,P<0.05)。手术前,两组GOS、NHISS及Barthel指数评分比较,差异无统计学意义(P>0.05);术后6个月,观察组GOS及Barthel指数评分高于对照组,NHISS评分低于对照组,差异均有统计学意义(P<0.05)。结论充分减压法开颅术较标准大骨瓣开颅术治疗重型颅脑创伤更具临床优势,不仅可以明显降低患者颅内压,同时还有助于提升手术预后质量,改善患者神经功能及生活自理能力,值得在临床中推广运用。Objective To explore the application effect of sufficient decompression method in the surgical treatment of severe brain injury,and to explore the safe and reliable surgical methods for severe brain injury.Methods Sixty patients with severe brain injury who underwent surgical treatment in Tengzhou Central People's Hospital from June 2021 to June 2022 were selected and divided into control group and observation group with 30 cases in each group by a computerized randomization method.The control group received standard large bone flap craniotomy treatment and the observation group received sufficient decompression method craniotomy treatment.The level of intracranial pressure,Glasgow outcome slae(GOS)score,national institute of health stroke scale(NIHSS)score and Barthel index score were compared between the two groups'patients.Results Before operation,there was no significant difference in intracranial pressure level between the two groups(P>0.05);the intracranial pressure levels at immediately,3 days and 7 days after operation in the observation group were(22.58±3.72),(15.11±5.33)and(14.28±4.83)mmHg,which were lower than those in the control group with(27.72±3.65),(23.01±6.47)and(19.41±5.06)mmHg,and the differences were statistically significant(t=4.351,5.161,4.015,P<0.05).Before operation,there were no significant differences in GOS,NHISS and Barthel index scores between two groups(P>0.05);6 months after operation,the GOS and Barthel index scores in the observation group were higher than those in the control group,while the NHISS score was lower than that in the control group,and the differences were statistically significant(P<0.05).Conclusion Sufficient decompression method craniotomy had more clinical advantages than standard large bone flap craniotomy in the treatment of severe brain injury,which could not only significantly reduce intracranial pressure of patients,but also help improve the quality of surgical prognosis,improve patients'neurological function and self-care ability.It was worth promoting

关 键 词：充分减压法开颅术 标准大骨瓣开颅术 重型颅脑创伤 颅内压 

分 类 号：R651.1[医药卫生—外科学]