目的 研究标准大骨瓣开颅减压手术(Standard Large Trauma Craniotomy Decompression,SLTC)对重症颅脑损伤患者颅内压及神经功能的影响.方法 随机选取2020年7月—2023年7月南平市第一医院收治的60例重症颅脑损伤患者为研究对象,根据其手术类型分为对照组(29例,予以传统骨瓣开颅减压手术处理)和观察组(31例,予以SLTC术处理),对比两组患者不同时间的颅内压、神经功能、脑氧代谢指标及并发症发生情况.结果 观察组术后第1、3、5天的颅内压均低于对照组,差异有统计学意义(P均<0.05).术后4周,观察组神经缺损状况得分低于对照组,差异有统计学意义(P<0.05).术后5 d,观察组神经元特异性烯醇化酶水平低于对照组,脑氧摄取率与静脉血氧饱和度高于对照组,差异有统计学意义(P均<0.05).观察组患者并发症总发生率(3.23%)低于对照组(24.14%),差异有统计学意义(χ2=4.005,P=0.045).结论 SLTC术可更有效降低重症颅脑损伤患者的颅内压,改善其神经功能及脑氧代谢状况,且并发症较少,手术安全性相对较高.
Effect of Standard Large Craniotomy Decompression on Intracranial Pres-sure and Nerve Function in Patients with Severe Craniocerebral Injury
Objective To investigate the effects of standard large trauma craniotomy decompression(SLTC)on intra-cranial pressure and nerve function in patients with severe craniocerebral injury.Methods A total of 60 patients with severe craniocerebral injury admitted to Nanping First Hospital from July 2020 to July 2023 were randomly selected as the study objects,and they were divided into the control group(29 cases,treated with traditional craniotomy decom-pression)and the observation group(31 cases,treated with SLTC)according to their surgical types.The intracranial pressure,nerve function,cerebral oxygen metabolism indexes and incidence of complications were compared between the two groups.Results The intracranial pressure of the observation group were lower than those of the control group at 1,3,and 5 d after operation,the differences were statistically significant(all P<0.05).4 weeks after operation,the score of nerve defect in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).5 d after operation,the neuron specific enolase in the observation group was lower than that in the control group,and the cerebral oxygen uptake rate and venous oxygen saturation were higher than those in the con-trol group,the differences were statistically significant(all P<0.05).The total incidence rate of complications in the ob-servation group(3.23%)was lower than that in the control group(24.14%),the difference was statistically significant(χ2=4.005,P=0.045).Conclusion SLTC treatment can more effectively reduce the intracranial pressure of patients with severe craniocerebral injury,improve their neurological function and brain oxygen metabolism,and have fewer complications and relatively high surgical safety.
Severe craniocerebral injuryStandard large craniotomy decompressionIntracranial pressureNeural function
万方数据
维普
