大骨瓣开颅手术治疗重症颅脑外伤的临床效果及对术后颅内感染的影响  

Clinical effect of large bone flap craniotomy surgery in the treatment of severe craniocerebral injury and its influence on postoperative intracranial infection

作　　者：程广东 赵成乐 CHENG Guangdong;ZHAO Chengle(No.1 Ward of Neurosurgery Department,Zhenping County People's Hospital,Nanyang 474250,China)

机构地区：[1]河南省镇平县人民医院神经外科一病区,河南南阳474250

出　　处：《临床医学研究与实践》2024年第31期79-82,共4页Clinical Research and Practice

摘　　要：目的分析大骨瓣开颅手术治疗重症颅脑外伤的临床效果。方法选取2017年6月至2023年6月我院收治的106例重症颅脑外伤患者为研究对象,根据开颅手术方法不同将其分为常规组(53例,传统骨瓣开颅减压术)和观察组(53例,大骨瓣开颅手术)。比较两组的手术效果。结果观察组的治疗总有效率高于常规组,差异具有统计学意义(P<0.05)。观察组的手术时长长于常规组,术中出血量多于常规组,术后卧床时长、总住院时长短于常规组,差异具有统计学意义(P<0.05)。术后第3、5、7天,观察组的简易智能精神状态检查量表(MMSE)评分高于常规组,差异具有统计学意义(P<0.05)。术后第3天,观察组的血氧饱和度、中心静脉压高于常规组,平均动脉压、颅内压、脑脊液压及脑灌注压低于常规组(P<0.05)。术后第3天,观察组的微循环抵抗指数、平均血流速度及循环血流阻力指数低于常规组,差异具有统计学意义(P<0.05)。观察组的外伤性脑膨出、颅内感染发生率低于常规组,差异具有统计学意义(P<0.05)。结论大骨瓣开颅手术治疗重症颅脑外伤患者具有较佳的手术效果与预后保障。Objective To analyze the clinical effect of large bone flap craniotomy surgery in the treatment of severe craniocerebral injury.Methods A total of 106 patients with severe craniocerebral injury admitted in our hospital from June 2017 to June 2023 were selected as the research objects.According to different craniotomy methods,the patients were divided into conventional group(53 cases,traditional bone flap craniotomy decompression surgery)and observation group(53 cases,large bone flap craniotomy surgery).The surgical effects of the two groups were compared.Results The total effective rate of treatment of the observation group was higher than that of the conventional group,and the difference was statistically significant(P<0.05).The operation time of the observation group was longer than that of the conventional group,the intraoperative blood loss was more than that of the conventional group,the postoperative bed time and total hospitalization time were shorter than those of the conventional group,and the differences were statistically significant(P<0.05).On the 3rd,5th and 7th day after operation,the Mini-Mental State Examination(MMSE)score of the observation group was higher than that of the conventional group,and the difference was statistically significant(P<0.05).On the 3rd day after operation,the blood oxygen saturation and central venous pressure in the observation group were higher than those in the conventional group,and the mean arterial pressure,intracranial pressure,cerebrospinal fluid pressure and cerebral perfusion pressure were lower than those in the conventional group(P<0.05).On the 3rd day after operation,the microcirculation resistance index,mean blood flow velocity and circulatory blood flow resistance index of the observation group were lower than those of the conventional group,and the differences were statistically significant(P<0.05).The incidence of traumatic encephalocele and intracranial infection in the observation group were lower than those in the conventional group(P<0.05).Conclusion L

关 键 词：重症颅脑外伤 大骨瓣开颅手术 传统骨瓣开颅减压术 

分 类 号：R651.15[医药卫生—外科学]