目的 分析标准外伤大骨瓣开颅术联合亚低温在重型颅脑外伤的效果.方法 选取 76 例重型颅脑外伤患者,按随机数字表法分为实验组(n=38)和对照组(n=38),对照组采用标准外伤大骨瓣开颅术治疗,实验组采取标准外伤大骨瓣开颅术联合亚低温治疗.对比两组临床疗效、颅内压水平、美国国立卫生研究院卒中量表(national institute of health stroke scale,NIHSS)评分、免疫功能(CD8+、CD4+)水平及并发症发生率.结果 实验组总有效率 94.74%(36/38)较对照组 73.68%(28/38)高(P＜0.05);治疗 1、2、3d后,实验组颅内压水平较对照组低(P＜0.05);治疗后,实验组NIHSS评分较对照组低(P＜0.05);治疗后,实验组CD8+水平较对照组低,CD4+水平较对照组高(P＜0.05);实验组并发症发生率 5.26%(2/38)较对照组 26.32%(10/38)低(P＜0.05).结论 标准外伤大骨瓣开颅术结合亚低温治疗重型颅脑外伤病人,可提高临床疗效,降低颅内压水平,改善神经功能损伤状态,改善免疫功能,减少术后并发症发生.
Application Effect of Standard Large Trauma Craniotomy Combined with Sub-low Temperature in Severe Craniocerebral Trauma
Objective To analyze the effect of standard large trauma craniotomy combined with mild-hypothermia in se-vere craniocerebral trauma.Methods 76 cases of patients with severe craniocerebral trauma were selected,and they all were divided into an experimental group(n=38)and a control group(n=38)according to the method of random number table.The control group was treated with standard large trauma craniotomy,while the experimental group was treated with standard large trauma craniotomy combined with mild-hypothermia.The clinical efficacy,intracranial pressure level,national institute of health stroke scale(NIHSS)score,immune function(CD8+、CD4+)level and complicationsoccurrence rate of the two groups were com-pared.Results The total effective rate 94.74%(36/38)of the experimental groupwas higher than73.68%(28/38)of the control group(P＜0.05);After 1d,2d and 3d of treatment,the levels of intracranial pressure in the experimental group was lower than that in the control group(P＜0.05);After treatment,the NIHSS score of the experimental group was lower than that of the control group(P＜0.05);After treatment,the level of CD8+ in the experimental group was lower than that in the control group,while the level of CD4+ was higher than that in the control group(P＜0.05);The occurrence rate of complications 5.26%(2/38)in the experimental group waslower than 26.32%(10/38)in the control group(P＜0.05).Conclusion The standard large trau-macraniotomy combined with mild-hypothermia in the treatment of severe craniocerebral trauma can improve the clinical effi-cacy,decrease the level of intracranial pressure,improve the state of neurological injury,improve the immune function and re-duce the occurrence ofpostoperative complications.
Severe craniocerebral traumaSub-low temperatureImmunityfunctionStandard large trauma craniotomy
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