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控制性阶梯式颅内减压术救治重型颅脑损伤患者的效果

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目的:探讨重型颅脑损伤采用控制性阶梯式颅内减压术进行救治的效果。方法:收集2021年1月—2023年2月在北京精诚博爱医院接受救治的 220 例重型颅脑损伤患者临床资料展开回顾性研究,根据救治使用术式不同将患者分为参照组(常规减压术,n=100)与研究组(控制性阶梯式颅内减压术,n=120)。比较两组相关手术指标、脑代谢指标、预后及并发症发生情况。结果:研究组术中出血量、甘露醇使用量较参照组少,手术持续时间较参照组短,差异有统计学意义(P<0。05);研究组术后脑血氧饱和度、动脉血氧分压高于参照组,差异有统计学意义(P<0。05);研究组并发症发生率低于参照组,差异有统计学意义(P<0。05);与参照组相比,研究组术后恢复良好率更高,中重度残疾率、植物生存率更低,差异有统计学意义(P<0。05)。结论:重型颅脑损伤患者临床救治中实施控制性阶梯式颅内减压术,能有效提高手术效果,且减少术后并发症,促进患者预后改善。
Effect of Controlled Stepped Intracranial Decompression in the Treatment of Patients with Severe Craniocerebral Injury
Objective:To investigate the effect of controlled stepped intracranial decompression in the treatment of severe craniocerebral injury.Method:The clinical data of 220 patients with severe craniocerebral injury who treated in Beijing Jingcheng Bo'ai Hospital from January 2021 to February 2023 were collected for retrospective study,the patients were divided into the reference group(conventional decompression,n=100)and the study group(controlled stepped intracranial decompression,n=120)according to the different surgical methods.The related surgical indexes,brain metabolism indexes,prognosis and complications were compared between two groups.Result:Compared with the reference group,the intraoperative blood loss and Mannitol consumption in the study group were less,and the operation duration was shorter,the differences were statistically significant(P<0.05).The cerebral oxygen saturation and arterial partial pressure of oxygen in the study group after operation were higher than those in the reference group,and the differences were statistically significant(P<0.05).The incidence of complications in the study group was lower than that in the reference group,and the difference was statistically significant(P<0.05).Compared with the reference group,the postoperative recovery rate of the study group was higher,the moderate and severe disability rate and plant survival rate were lower,and the differences were statistically significant(P<0.05).Conclusion:In the clinical treatment of patients with severe craniocerebral injury,controlled stepped intracranial decompression can effectively improve the surgical effect,reduce postoperative complications,and promote the improvement of patient prognosis.

Severe craniocerebral injuryControlled stepped intracranial decompressionComplicationsPrognosis

陈通恒、马敬、孙朝阳、李杰、王为文

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北京精诚博爱医院 北京 100015

北京华生康复医院

重型颅脑损伤 控制性阶梯式颅内减压术 并发症 预后

2024

中外医学研究
中国医院管理杂志社

中外医学研究

影响因子:1.149
ISSN:1674-6805
年,卷(期):2024.22(14)
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