显微镜下标准大骨瓣减压术对颅脑损伤患者脑血流动力学及并发症的影响
Effect of Standard Large Bone Flap Decompression Under Microscope on Cerebral Hemodynamics and Complications in Patients with Craniocerebral Injury
李师臣1
作者信息
- 1. 临朐县人民医院神经外二科,山东潍坊 261000
- 折叠
摘要
目的 探讨显微镜下标准大骨瓣减压术对颅脑损伤患者脑血流动力学及并发症的影响.方法 选取该院2020 年1 月—2023 年9 月收治的 82例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与观察组,各 41例.对照组采用传统大骨瓣减压手术,观察组采用显微镜下标准大骨瓣减压术.对比两组患者的脑血流动力学指标、血清学指标、颅内压、意识状态、并发症发生情况.结果 术后 7d,观察组平均通过时间、达峰时间分别为(2.04±0.25)s、(13.05±1.22)s,均短于对照组的(2.89±0.31)s、(15.24±1.25)s,脑血流量、脑血容量分别为(33.52±3.48)mL/(100g·min)、(2.57±0.32)mL/100 g,均高于对照组的(26.89±3.12)mL/(100 g·min)、(2.15±0.28)mL/100 g,组间差异有统计学意义(P＜0.05).术后 7d,观察组超敏C反应蛋白、肿瘤坏死因子-α、人单核细胞趋化蛋白-1 水平分别为(7.68±1.13)mg/L、(10.32±1.22)μg/L、(215.24±20.36)ng/L,均低于对照组的(9.25±1.17)mg/L、(13.47±1.28)μg/L、(254.71±25.89)ng/L,组间差异有统计学意义(P＜0.05);观察组颅内压为(10.12±1.09)mmHg,低于对照组的(13.07±1.22)mmHg,意识状态评分为(14.52±1.19)分,高于对照组的(12.63±1.04)分,组间差异有统计学意义(P＜0.05).两组并发症发生率对比,差异无统计学意义(P＞0.05).结论 显微镜下标准大骨瓣减压术治疗颅脑损伤患者效果确切,可减轻患者脑血流动力学损害,避免其机体炎症过度反应,改善患者病情,安全可行.
Abstract
Objective To investigate the effects of standard large bone flap decompression under microscope on cerebral hemodynamics and complications in patients with craniocerebral injury.Methods A total of 82 patients with craniocerebral injury admitted to the hospital from January 2020 to September 2023 were selected as the study objects,and they were divided into a control group and an observation group according to random number table method,with 41 cases in each group.The control group was treated with traditional large bone flap decompression,and the observation group was treated with standard large bone flap decompression under microscope.The cerebral hemodynamic index,serological index,intracranial pressure,conscious state and complications were compared between the two groups.Results Seven days after operation,the mean transit time and peak time of the observation group were(2.04±0.25)s and(13.05±1.22)s,which were shorter than(2.89±0.31)s and(15.24±1.25)s of the control group,respectively.Cerebral blood flow and cerebral blood volume were(33.52±3.48)mL/(100 g·min)and(2.57±0.32)mL/100 g in the observation group,respectively,which higher than(26.89±3.12)mL/(100 g·min)and(2.15±0.28)mL/100 g of the control group,respectively,the differences between the groups were statistically significant(P＜0.05).The levels of hypersensitive C-reactive protein,tumor necrosis factor-α and human monocyte chemoattractant protein-1 in the observation group were(7.68±1.13)mg/L,(10.32±1.22)μg/L and(215.24±20.36)ng/L,respectively,which were lower than(9.25±1.17)mg/L,(13.47±1.28)μg/L,(254.71±25.89)ng/L of the control group,and the differences between the two groups were statistically significant(P＜0.05);the intracranial pressure in the observation group was(10.12±1.09)mmHg,which was lower than(13.07±1.22)mmHg in the control group,and the State of consiciousness score was(14.52±1.19)points,which was higher than(12.63±1.04)points in the control group,the differences between the two groups were statistically significant(P＜0.05).There was no significant difference in the incidence of complications between the two groups(P＞0.05).Conclusion Standard large bone flap decompression under microscope is effective in the treatment of patients with craniocerebral injury,which can reduce the cerebral hemodynamic damage,avoid the overreaction of the body inflammation,improve the condition of patients,and is safe and feasible.
关键词
颅脑损伤/显微镜下标准大骨瓣减压术/脑血流动力学/并发症Key words
Craniocerebral injury/Standard large bone flap decompression under microscope/Cerebral hemodynamics/Complication引用本文复制引用
出版年
2024
NETL
NSTL
万方数据