阶梯式大骨瓣减压术治疗重型颅脑损伤的效果及对患者术后认知功能的影响
Effect of Stepwise Large Craniotomy Decompression in the Treatment of Severe Craniocerebral Injury and Its Influence on Postoperative Cognitive Function
王鹏1
作者信息
- 1. 741000 甘肃 天水,天水市第一人民医院神经外科
- 折叠
摘要
目的 探讨阶梯式大骨瓣减压术治疗重型颅脑损伤的效果,以及对患者术后认知功能的影响.方法 选择天水市第一人民医院2020年6月—2023年6月收治的80例重型颅脑损伤患者作为研究对象,按照手术类型的不同分为采用阶梯式大骨瓣减压术治疗的阶梯组40例,以及采用标准大骨瓣减压术治疗的对照组40例.观察并比较两组术前和术后颅内压水平、格拉斯哥昏迷量表评分,以及术后认知功能、手术相关指标、住院时间、并发症发生情况.结果 术后,两组颅内压水平和格拉斯哥昏迷量表评分均较术前得到改善,差异有统计学意义(P＜0.05).术后,阶梯组颅内压水平低于对照组,格拉斯哥昏迷量表评分和认知功能评分高于对照组,差异均有统计学意义(P＜0.05).阶梯组术中出血量少于对照组,手术时间和住院时间短于对照组,差异均有统计学意义(P＜0.05).阶梯组并发症发生率低于对照组,差异有统计学意义(P＜0.05).结论 阶梯式大骨瓣减压术治疗重型颅脑损伤,较标准大骨瓣减压术可进一步降低颅内压,缩短手术时间,减少术中出血量和住院时间,降低并发症发生率,改善患者的认知功能和预后.
Abstract
Objective To explore the efficacy of stepwise large craniotomy decompression in the treatment of severe craniocerebral injury and its influence on postoperative cognitive function.Methods A total of 80 patients with severe craniocerebral injury admitted to the First People's Hospital of Tianshui from June 2020 to June 2023 were selected as the research objects.According to the different types of surgeries,they were divided into a stepwise group of 40 patients treated with stepwise large craniotomy decompression and a control group of 40 patients treated with standard large craniotomy decompression.Observe and compare the preoperative and postoperative intracranial pressure levels,Glasgow Coma Scale scores,as well as the postoperative cognitive function,surgical related indicators,hospitalization time,and incidence of complications between two groups.Results After surgery,the intracranial pressure levels and Glasgow Coma Scale scores of the two groups improved significantly compared to before surgery(P<0.05).After surgery,the intracranial pressure level in the stepwise group was significantly lower than that in the control group,and the Glasgow Coma Scale scores and cognitive function scores were significantly higher than those in the control group(P<0.05).The intraoperative bleeding volume in the stepwise group was significantly less than that in the control group,and the surgical and hospitalization time were significantly shorter than those in the control group(P<0.05).The incidence of complications in the stepwise group was significantly lower than that in the control group(P<0.05).Conclusion Compared with standard large craniotomy decompression surgery,stepwise large craniotomy decompression surgery can further reduce intracranial pressure,shorten surgical time,reduce intraoperative bleeding volume and hospitalization time,decrease the incidence of complications,improve patient's cognitive function and prognosis in treatment of severe craniocerebral injury.
关键词
重型颅脑损伤/手术治疗/阶梯式大骨瓣减压术/认知功能/疗效Key words
Severe Craniocerebral Injury/Surgical Treatment/Stepwise Large Craniotomy Decompression Surgery/Cognitive Function/Curative effect引用本文复制引用
出版年
2024
NETL
NSTL
万方数据