分步减压术治疗重型颅脑损伤的临床应用
摘要
目的研究分步减压术治疗重型颅脑损伤的临床效果。方法选取宿州市立医院神经外科2014年1月至2017年2月收治重型颅脑损伤63例,根据手术方式分为对照组标准大骨瓣减压术治疗34例,观察组分步减压术治疗29例。比较两组术后并发症发生率,术后6个月格拉斯哥昏迷评分(GCS)、神经行为认知状态检查表评分(NCSE)、日常生活活动能力评分(Barthel指数)。结果观察组GCS、NCSE及Barthel指数均明显高于对照组(P<0.01);观察组总并发症发生率(20.67%)明显低于对照组(50.00%)(P=0.00),观察组预后良好率(51.70%)明显高于对照组(26.47%)(P=0.00)。结论分步减压术能促进重型颅脑损伤患者神经功能和生活质量恢复,降低术中和术后并发症风险,改善患者预后,值得在临床推广。
引文
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[15]包贇,邱炳辉,曾浩,等.重型颅脑损伤去骨瓣减压术后颅内压升高的亚低温治疗[J].中国临床神经外科杂志,2016,24(11):657~660.
[2]Xu G,Hu B,Chen G,et al.Analysis of blood trace elements and biochemical indexes levels in severe craniocerebral trauma adults with Glasgow Coma Scale and injury severity score.[J].Biological Trace Element Research,2015,164(2):192~197.
[3]Zhao J X,Guo Q,Yuan Y,et al.Scalp Avulsion Combined with Unusual Severe Open Craniocerebral Avulsion Injury[J].中华医学杂志(英文版),2015,128(20):2839~2845.
[4]王继仁,吕伟昌,王立鹏,等.标准大骨瓣减压术与常规去骨瓣减压术治疗重型颅脑损伤效果对比分析[J].检验医学与临床,2016,13(2):303~305.
[5]陈亚军,蒋宇钢,刘少波.控制性阶梯式减压术治疗重型、特重型颅脑损伤疗效分析[J].中国临床神经外科杂志,2015,11(3):740~742.
[6]Jiang W W,Wang Q H,Liao Y J,et al.Effects of dexmedetomidine on TNF-αand interleukin-2in serum of rats with severe craniocerebral injury[J].Bmc Anesthesiology,2017,17(1):130~135.
[7]李锐,郎志刚,欧阳荣健.重型颅脑损伤改良大骨瓣减压术的疗效[J].创伤外科杂志,2016,18(8):500~502.
[8]王首杰,高国栋,秦怀洲.标准去大骨瓣开颅减压术治疗重型颅脑损伤临床疗效观察[J].神经损伤与功能重建,2014,20(6):498~500.
[9]Shi L,Sun G,Qian C,et al.Technique of Stepwise Intracranial Decompression Combined with External Ventricular Drainage Catheters Improves the Prognosis of Acute Post-Traumatic Cerebral Hemispheric Brain Swelling Patients[J].Frontiers in Human Neuroscience,2015,9(13):535~541.
[10]Xu L,Li B,Yang C,et al.Clinical research on postoperative efficacy and related factors of early simulation hyperbaric oxygen therapy for severe craniocerebral injury[J].Pakistan Journal of Pharmaceutical Sciences,2016,29(1):273~280.
[11]赵龙,刘泉,林岚.标准大骨瓣减压术对重型颅脑损伤患者脑血流动力学及代谢状态的影响[J].实用临床医药杂志,2016,20(19):83~85.
[12]Huempfnerhierl H,Schaller A,Hierl T.Maxillofacial fractures and craniocerebral injuries-stress propagation from face to neurocranium in a finite element analysis[J].Scandinavian Journal of Trauma Resuscitation&Emergency Medicine,2015,23(1):1~9.
[13]张龙,刘保国,何黎明,等.均衡性与非均衡性去骨瓣减压术治疗重型颅脑损伤的效果比较[J].广东医学,2014,35(4):547~549.
[14]Thomas A G,Hegde S V,Dineen R A,et al.Patterns of accidental craniocerebral injury occurring in early childhood[J].Archives of Disease in Childhood,2014,40(1):145~146.
[15]包贇,邱炳辉,曾浩,等.重型颅脑损伤去骨瓣减压术后颅内压升高的亚低温治疗[J].中国临床神经外科杂志,2016,24(11):657~660.