摘要
目的总结和分析重型颅脑损伤合并脑疝患者采取大骨瓣减压术治疗的临床效果。方法84例重型颅脑损伤合并脑疝患者,根据治疗方法的不同分为常规减压组及大骨瓣减压组,各42例。常规减压组患者选择常规去骨瓣减压术治疗,大骨瓣减压组患者采取大骨瓣减压术治疗。对比两组患者的手术预后情况及手术前后神经功能缺损评分、颅内压。结果大骨瓣减压组患者的预后较好率为73.8%,明显高于常规减压组的45.2%,差异具有统计学意义(P<0.05)。术前,两组患者的神经功能缺损评分及颅内压对比,差异无统计学意义(P>0.05);术后1个月,大骨瓣减压组患者的神经功能缺损评分(16.22±2.31)分低于常规减压组的(27.03±7.26)分,差异具有统计学意义(P<0.05);术后10d,大骨瓣减压组患者的颅内压(12.76±2.49)mmHg(1mmHg=0.133kPa)低于常规减压组的(21.08±3.93)mm Hg,差异具有统计学意义(P<0.05)。结论重型颅脑损伤合并脑疝患者采用大骨瓣减压术的预后效果较好,同时能够改善患者的神经功能缺损情况,降低颅内压,适合在临床进一步研究及推广。
Objective To summarize and analyze the clinical effect of large bone flap decompression in the treatment of severe craniocerebral injury and cerebral hernia.Methods A total of 84 patients with severe craniocerebral injury and cerebral herniation were divided into conventional decompression group and large bone flap decompression group according to different treatment methods,with 42 cases in each group.Patients in the conventional decompression group were treated with conventional debridement decompression,while patients in the large bone flap decompression group were treated with large bone flap decompression.The surgical prognosis and the neurological deficit score and intracranial pressure before and after surgery were compared between the two groups.Results The good prognosis rate of patients in the large bone flap decompression group was 73.8%,which was significantly higher than 45.2%of the conventional decompression group,and the difference was statistically significant(P<0.05).Before surgery,the neurological deficit score and intracranial pressure of the two groups were compared,and the difference was not statistically significant(P>0.05).At 1 month after surgery,the neurological deficit score of patients in the large bone flap decompression group was(16.22±2.31)points,which was lower than(27.03±7.26)points in the conventional decompression group,and the difference was statistically significant(P<0.05).At 10 d after surgery,the intracranial pressure of patients in the large bone flap decompression group was(12.76±2.49)mm Hg(1mmHg=0.133 kPa),which was lower than(21.08±3.93)mm Hg in the conventional decompression group,and the difference was statistically significant(P<0.05).Conclusion The prognosis of large bone flap decompression for patients with severe craniocerebral injury and cerebral hernia is good,and it can improve the neurological deficit and reduce intracranial pressure of patients,which is suitable for further clinical research and promotion.
作者
朱明
ZHU Ming(Second Neurological Ward,Tieling Central Hospital,Tieling 112000,China)
出处
《中国现代药物应用》
2023年第2期58-60,共3页
Chinese Journal of Modern Drug Application
关键词
重型颅脑损伤
脑疝
大骨瓣减压术
健康宣教
Severe craniocerebral injury
Cerebral hernia
Large bone flap decompression
Health education
