Effect of Modified Large Bone Flap Decompression Combined with Continuous Lumbar Cistern Drainage in the Treatment of Severe Craniocerebral Injury with Subarachnoid Hemorrhage
Objective:To observe the effect of modified large bone flap decompression combined with continuous lumbar cistern drainage in the treatment of severe craniocerebral injury with subarachnoid hemorrhage.Method:Sixty patients with severe craniocerebral injury with subarachnoid hemorrhage who admitted to the Neurosurgery Department of Gaoling District Hospital in Xi'an from August 2020 to May 2023 were selected as the study objects,and they were randomly divided into the study group and the control group according to the random number table method,with 30 patients in each group.Two groups were treated with modified large bone flap decompression,on this basis,the control group was given routine lumbar puncture drainage,while the study group was given continuous lumbar cistern drainage,the improvement of clinical symptoms,prognosis at 3 months after operation,complications within 1 month after operation and neurological function at 5 d and 1 month after operation were compared between two groups.Result:The hematoma clearance rate and good prognosis rate at 3 months after operation in the study group were higher than those in the control group,the cerebrospinal fluid clearance time was shorter than that in the control group,and the incidence of complications within 1 month after operation was lower than that in the control group,the differences were statistically significant(P<0.05).At 7 d after operation,the intracranial pressure of two groups were decreased compared with those at 5 d after operation,and that of the study group was lower than that of the control group,the differences were statistically significant(P<0.05).At 1 month after operation,the netrin-1 level of two groups increased,and the modified Rankin scale(MRS)score decreased,and the netrin-1 level of the study group was higher than that of the control group,and the MRS score was lower than that of the control group,the differences were statistically significant(P<0.05).Conclusion:Modified large bone flap decompression combined with continuous lumbar cistern drainage can promote the hematoma clearance in patients with severe craniocerebral injury with subarachnoid hemorrhage,reduce the intracranial pressure and postoperative complications risk,improve neurological function and prognosis.
Modified large bone flap decompressionContinuous lumbar cistern drainageSevere craniocerebral injurySubarachnoid hemorrhagePrognostic manifestations
万方数据
维普
