渐进性减压治疗重型颅脑损伤效果观察
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摘要
目的比较渐进性减压与常规减压治疗重型颅脑损伤的效果。方法选取本院2016年1月至2018年12月收治的重型颅脑损伤患者90例作为研究对象,随机分为观察组和对照组各45例,观察组采用渐进性减压,对照组采用常规减压,比较两组患者手术情况、手术前后颅内压、手术前后GCS评分、并发症、术后预后良好率。结果观察组术后1d、5d、10d颅内压值低于对照组,差异有统计学意义(P<0.05);观察组术后10d、1个月GCS值均高于术后对照组,差异有统计学意义(P<0.05);观察组术后并发症发生率明显低于对照组,差异有统计学意义(P<0.05);观察组术后恢复良好率高于对照组,差异有统计学意义(P<0.05);观察组术后5个月死亡率低于对照组,差异有统计学意义(P<0.05)。结论渐进性减压治疗重型颅脑损伤疗效较好,可降低术后并发症的发生率,患者预后效果较好。
Objective To compare the effects of progressive decompression and conventional decompression on severe craniocerebral injury.Methods A total of 90 patients with severe craniocerebral injury in our hospital from January 2016 to December 2018 were selected and randomly divided into observation group and control group,with 45 cases in each group.The observation group was treated with progressive decompression,and the control group was treated with conventional decompression.The operation conditions,intracranial pressure before and after operation,GCS score before and after operation,complications and good postoperative prognosis rate were compared between the two groups.Results The intracranial pressure values in observation group were lower than those in control group at 1 d,5 dand 10 dafter operation(P<0.05).The GCS values at 10 d and 1 month after operation in observation group were higher than those in control group(P<0.05).The incidence rates of postoperative complications in observation group were significantly lower than those in control group(P<0.05).The good rate of postoperative recovery in observation group was higher than that in control group(P<0.05).The mortality rate in observation group at 5 months after operation was lower than that in control group(P<0.05).Conclusion Progressive decompression has good efficacy in the treatment of severe craniocerebral injury,and it can reduce the incidence rates of postoperative complications,and it has good prognosis effects.
Objective To compare the effects of progressive decompression and conventional decompression on severe craniocerebral injury.Methods A total of 90 patients with severe craniocerebral injury in our hospital from January 2016 to December 2018 were selected and randomly divided into observation group and control group,with 45 cases in each group.The observation group was treated with progressive decompression,and the control group was treated with conventional decompression.The operation conditions,intracranial pressure before and after operation,GCS score before and after operation,complications and good postoperative prognosis rate were compared between the two groups.Results The intracranial pressure values in observation group were lower than those in control group at 1 d,5 dand 10 dafter operation(P<0.05).The GCS values at 10 d and 1 month after operation in observation group were higher than those in control group(P<0.05).The incidence rates of postoperative complications in observation group were significantly lower than those in control group(P<0.05).The good rate of postoperative recovery in observation group was higher than that in control group(P<0.05).The mortality rate in observation group at 5 months after operation was lower than that in control group(P<0.05).Conclusion Progressive decompression has good efficacy in the treatment of severe craniocerebral injury,and it can reduce the incidence rates of postoperative complications,and it has good prognosis effects.
引文
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[14]权瑜,巩守平,吕健,等.控制性减压术对中老年重型颅脑损伤的治疗效果评价[J].解放军医药杂志,2016,28(2):66-68.
[2]甘宁,刘思思,李英姿,等.重型颅脑损伤患者改良大骨瓣减压术中渐进减压与常规减压对比观察[J].山东医药,2017,57(27):70-72.
[3]徐亮,张相双,王维东,等.重型颅脑损伤65例标准大骨瓣开颅治疗体会[J].临床神经外科杂志,2016,13(2):150-151.
[4]翟红燕,张启田,梁青.重症颅脑损伤患者发生肺部感染的危险因素及防治[J].中国感染控制杂志,2017,16(2):182-185.
[5]李会兵,陈谦学.颅内压监测对重度颅脑外伤行开颅血肿清除术患者GCS评分、并发症及预后的影响[J].实用临床医药杂志,2017,21(11):73-76.
[6]沈亮,苏忠周,周跃.控制减压治疗重型颅脑损伤的Meta分析[J].中华创伤杂志,2016,32(5):406-409.
[7]宋雅婷.外伤性重型颅脑损伤并发迟发性颅内血肿预后相关影响因素分析[J].中国医学前沿杂志(电子版),2017,9(9):83-86.
[8]何明亮,易铭佳,何永通,等.控制减压与常规开颅减压治疗重型颅脑损伤的临床效果比较[J].浙江医学,2016,38(18):1523-1525.
[9]谢树波,蔡玮,杨立业,等.阶梯减压式去骨瓣减压术对重型颅脑损伤术后转归的影响[J].中国临床神经外科杂志,2017,22(7):493-495.
[10]周待令.控制性阶梯式减压术治疗重型颅脑损伤68例临床分析[J].中国实用神经疾病杂志,2016,19(20):39-41.
[11]袁雪松,卞小星,魏文峰,等.分布控制性减压治疗重型脑外伤的临床应用[J].国际神经病学神经外科学杂志,2015,2(2):155-158.
[12]蔡舒,管义祥.控制减压与开颅常规减压治疗重型颅脑损伤的对照研究[J].现代仪器与医疗,2017,23(6):100-101.
[13]罗越岭,叶党华,谭占国.逐步减压技术在重型、特重型颅脑损伤救治中的应用[J].中国临床神经外科杂志,2017,22(7):495-496.
[14]权瑜,巩守平,吕健,等.控制性减压术对中老年重型颅脑损伤的治疗效果评价[J].解放军医药杂志,2016,28(2):66-68.