观察标准大骨瓣减压术对重型颅脑损伤患者脑氧代谢指标、颅内压及预后情况的影响  

Observation of the Effects Of Standard Trauma Craniectomy on Cerebral Oxygen Metabolism Indicators,Intracranial Pressure and Prognosis in Patients with Severe Traumatic Brain Injury

作　　者：贾忠林 JIA Zhonglin(Department of No.2 Surgery,Penglai Traditional Chinese Medicine Hospital in Yantai City,Yantai 265600,China)

机构地区：[1]烟台市蓬莱中医医院外二科,山东烟台265600

出　　处：《反射疗法与康复医学》2024年第22期141-144,共4页Reflexology And Rehabilitation Medicine

摘　　要：目的探讨标准大骨瓣减压术(STC)对重型颅脑损伤患者的影响。方法选取2021年1月—2023年12月烟台市蓬莱中医医院收治的60例重型颅脑损伤患者为研究对象,按随机数字表法将其分为对照组和观察组,各30例。对照组行常规骨瓣减压术,观察组行STC。比较两组的手术情况、脑氧代谢指标、颅内压、神经功能、预后情况及并发症发生情况。结果观察组手术时间长于对照组,术中出血量多于对照组,住院时间短于对照组,组间差异有统计学意义(P<0.05)。术后1周,观察组脑氧摄取率、静脉血氧饱和度、脑灌注压水平均高于对照组,组间差异有统计学意义(P<0.05);观察组颅内压、美国国立卫生研究院卒中量表评分均低于对照组,格拉斯哥预后评分高于对照组,组间差异有统计学意义(P<0.05)。观察组并发症发生率为6.67%,低于对照组的26.67%,差异有统计学意义(P<0.05)。结论相比于常规骨瓣减压术,STC治疗重型颅脑损伤患者的效果更佳,有利于充分减压,可减轻神经功能损伤,且并发症少,整体预后更佳。Objective Exploring the effect of standard trauma craniectomy(STC)on patients with severe traumatic brain injury.Methods Selecting 60 patients with severe traumatic brain injury admitted to Penglai Traditional Chinese Medicine Hospital in Yantai City from January 2021 to December 2023 as the research subjects,according to the random number table method,they were divided into a control group and an observation group,with 30 cases in each group.The control group underwent conventional decompressive craniectomy,while the observation group underwent STC.Compare the surgical situation,cerebral oxygen metabolism indicators,intracranial pressure,neurological function,prognosis,and incidence of complications between two groups.Results The surgery time of the observation group was longer than that of the control group,the intraoperative blood output was greater than that of the control group,and the hospitalization time was shorter than that of the control group,the differences between the groups were statistically significant(P<0.05).One week after surgery,the cerebral extraction of oxygen,venous oxygen saturation,and cerebral perfusion pressure in the observation group were higher than those in the control group,the differences between the groups were statistically significant(P<0.05);the intracranial pressure and National Institutes of Health Stroke Scale score in the observation group were lower than those in the control group,while the Glasgow Outcome Scale score was higher than that in the control group,the differences between the groups were statistically significant(P<0.05).The incidence of complications in the observation group was 6.67%,which was lower than the 26.67%in the control group,the difference was statistically significant(P<0.05).Conclusion Compared with conventional decompressive craniectomy, STC has better efficacy in treating patients with severe traumatic brain injury, which is beneficial for sufficient decompression, can reduce neurological damage, and has fewer complications, resulting in a bette

关 键 词：重型颅脑损伤 标准大骨瓣减压术 脑氧代谢指标 颅内压 

分 类 号：R651.1[医药卫生—外科学]