高压氧联合标准外伤大骨瓣减压手术治疗重型颅脑外伤的预后分析
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摘要
目的探究重型颅脑外伤中高压氧联合标准外伤大骨瓣减压手术治疗的预后效果。方法方便选择该院2010年1月—2017年3月收治的60例重型颅脑外伤患者,根据出血情况的不同进行分组,颅内未出血患者为对照组,颅内出血患者标记为观察组,分别采用单纯减压术治疗和高压氧联合减压术治疗,比较两组患者手术治疗效果、并发症及康复情况。结果对照组患者抢救成功率为83.33%,死亡率为16.67%,观察组患者抢救成功率90.00%,死亡率为10.00%,观察组患者手术治疗效果显著优于对照组患者(P<0.05);对照组患者术后昏迷GCS评分(9.17±2.10)分,并发症发生率为26.67%,康复优良率为53.33%;观察组患者GCS评分(12.39±1.84)分,并发症发生率为13.33%,康复优良率为70.00%,观察组患者预后情况显著优于对照组(P<0.05)。结论在重型颅脑外伤患者减压手术抢救治疗中,联合高压氧治疗可有效改善受损脑组织缺氧状态,提高脑组织含氧量促进组织和神经功能修复,提高手术治疗效果,降低术后继发脑损伤,安全性和稳定好,有效改善患者术后预后。
Objective To study the prognosis of high pressure oxygen and standard trauma big bone disc decompression surgery in treatment of severe craniocerebral injury. Methods Convenient selection 60 cases of patients with severe craniocerebral injury admitted and treated in our hospital from January 2010 to March 2017 were selected and divided into two groups according to different bleeding situations, the control group were the patients without intracranial hemorrhage, while the observation group were the patients with intracranial hemorrhage, and both groups were respectively treated with simple decompression surgery and high pressure oxygen and standard trauma big bone disc decompression surgery, and the treatment effect, complications and rehabilitation situations were compared between the two groups. Results The rescue success rate and death rate in the observation group were better than those in the control group(90.00%, 10.00% vs 83.33%,16.67%)(P<0.05), and the postoperative coma GCS score, incidence rate of complications, excellent and good rate of rehabilitation in the observation group were better than those in the control group [(9.17 ±2.10)points, 26.67%, 53.33% vs(12.39±1.84)points, 13.33%, 70.00%](P<0.05). Conclusion The high pressure oxygen and standard trauma big bone disc decompression surgery in treatment of severe craniocerebral injury can effectively improve the injured brain tissues anaerobic condition, improve the brain tissues oxygen content and nerve function repair, improve the operation treatment effect and reduce the postoperative secondary injury with good safety and stability thus effectively improving the postoperative prognosis of patients.
Objective To study the prognosis of high pressure oxygen and standard trauma big bone disc decompression surgery in treatment of severe craniocerebral injury. Methods Convenient selection 60 cases of patients with severe craniocerebral injury admitted and treated in our hospital from January 2010 to March 2017 were selected and divided into two groups according to different bleeding situations, the control group were the patients without intracranial hemorrhage, while the observation group were the patients with intracranial hemorrhage, and both groups were respectively treated with simple decompression surgery and high pressure oxygen and standard trauma big bone disc decompression surgery, and the treatment effect, complications and rehabilitation situations were compared between the two groups. Results The rescue success rate and death rate in the observation group were better than those in the control group(90.00%, 10.00% vs 83.33%,16.67%)(P<0.05), and the postoperative coma GCS score, incidence rate of complications, excellent and good rate of rehabilitation in the observation group were better than those in the control group [(9.17 ±2.10)points, 26.67%, 53.33% vs(12.39±1.84)points, 13.33%, 70.00%](P<0.05). Conclusion The high pressure oxygen and standard trauma big bone disc decompression surgery in treatment of severe craniocerebral injury can effectively improve the injured brain tissues anaerobic condition, improve the brain tissues oxygen content and nerve function repair, improve the operation treatment effect and reduce the postoperative secondary injury with good safety and stability thus effectively improving the postoperative prognosis of patients.
引文
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[6]庞军,倪晓伟,兰杰,等.标准外伤大骨瓣减压术联合术后腰大池引流术治疗重型颅脑损伤临床分析[J].浙江创伤外科,2011,16(2):198-199.
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[8]刘宝江,王守臣,李光雷,等.高压氧联合标准外伤大骨瓣减压手术治疗重型颅脑损伤临床分析[J].临床和实验医学杂志,2013,12(9):673-675.
[2]黄锦丰,凌国源,玉石,等.标准外伤大骨瓣开颅术联合亚低温治疗重型颅脑损伤疗效观察[J].牡丹江医学院学报,2016,37(3):10-12.
[3]郭燕春,谢泽宇.改良外伤大骨瓣减压术联合高压氧治疗重型颅脑损伤[J].中国实用神经疾病杂志,2015,18(14):20-21.
[4]江永嘉.高压氧联合标准外伤大骨瓣减压手术治疗重型颅脑损伤的临床疗效[J].中国实用医药,2015,10(12):133-134.
[5]于新华,由春玲,杨文辰,等.标准外伤大骨瓣减压术治疗额颞顶部重型颅脑损伤预后分析[J].中国现代医学杂志,2010,20(11):1690-1692.
[6]庞军,倪晓伟,兰杰,等.标准外伤大骨瓣减压术联合术后腰大池引流术治疗重型颅脑损伤临床分析[J].浙江创伤外科,2011,16(2):198-199.
[7]葛海涛.标准外伤大骨瓣减压术治疗额颞顶部重型颅脑损伤预后分析[J].疑难病杂志,2011,10(2):132-133.
[8]刘宝江,王守臣,李光雷,等.高压氧联合标准外伤大骨瓣减压手术治疗重型颅脑损伤临床分析[J].临床和实验医学杂志,2013,12(9):673-675.