标准大骨瓣减压术治疗重型颅脑损伤的临床疗效及预后观察
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摘要
目的探求重型颅脑损伤患者采用标准大骨瓣减压术治疗对其疗效及预后的影响。方法选择某院2015年10月至2017年7月收治的重型颅脑损伤患者102例,将其按抽签法分为两组,每组各51例。对照组采用常规骨瓣开颅术治疗,观察组采用标准大骨瓣减压术治疗,随访6个月,比较两组临床疗效、颅内压与炎症因子水平、美国国立卫生院神经功能缺损评分(NIHSS)与日常生活活动能力表(ADL)评分、并发症发生率。结果观察组治疗总有效率74.51%、ADL评分(75.64±9.65)分较对照组54.90%、(60.32±10.24)分高,颅内压(13.41±2.68)mmHg(1 mmHg=0.133 kPa)、C反应蛋白(CR P)(9.14±2.06)mg/L、白介素-6 (IL-6)(5.26±1.12)ng/L、并发症发生率7.84%较对照组(21.26±3.24)mmHg、(13.20±3.12)mg/L、(7.20±1.65)ng/L、23.53%低,差异具有统计学意义(P<0.05)。结论标准大骨瓣减压术可减轻重型颅脑损伤患者机体炎症反应,降低颅内压及并发症发生率,提高日常活动能力,改善患者预后。
Objective To investigate the clinical efficacy of standard large trauma craniotomy in the treatment of severe traumatic brain injury(STBI) and its influence on prognosis.Me thods 102 STBI patients in a hospital from October 2015 to July 2017 were selected and divided into two groups by draw lots,with 51 cases in each group.The control group was given routine craniotomy with bone flap while the observation group was treated with standard large trauma craniotomy.After 6-month follow-up,the clinical efficacy,intracranial pressure,levels of inflammatory factors,NIHSS and ADL scores,incidence of complications were compared between the two groups.Re s ults The total effective rate and ADL score of the observation group[(74.51%),(75.64 ±9.65)points] were higher than those of the control group [(54.90%),(60.32 ±10.24)points] while the intracranial pressure,CRP,IL-6,incidence of complications in the observation group[(13.41±2.68)mmHg(1 mm Hg=0.133 kPa),(9.14±2.06)mg/L,(5.26±1.12)ng/L,(7.84%)] were lower than those in the control group[(21.26±3.24)mmHg,(13.20±3.12)mg/L,(7.20±1.65)ng/L,(23.53%)].The difference was of statistical significance( P <0.05).Conclus ion Standard large trauma craniotomy in the treatment of STBI could reduce inflammatory response,decrease intracranial pressure and incidence of complications,increasing activity of daily living and improving prognosis.
Objective To investigate the clinical efficacy of standard large trauma craniotomy in the treatment of severe traumatic brain injury(STBI) and its influence on prognosis.Me thods 102 STBI patients in a hospital from October 2015 to July 2017 were selected and divided into two groups by draw lots,with 51 cases in each group.The control group was given routine craniotomy with bone flap while the observation group was treated with standard large trauma craniotomy.After 6-month follow-up,the clinical efficacy,intracranial pressure,levels of inflammatory factors,NIHSS and ADL scores,incidence of complications were compared between the two groups.Re s ults The total effective rate and ADL score of the observation group[(74.51%),(75.64 ±9.65)points] were higher than those of the control group [(54.90%),(60.32 ±10.24)points] while the intracranial pressure,CRP,IL-6,incidence of complications in the observation group[(13.41±2.68)mmHg(1 mm Hg=0.133 kPa),(9.14±2.06)mg/L,(5.26±1.12)ng/L,(7.84%)] were lower than those in the control group[(21.26±3.24)mmHg,(13.20±3.12)mg/L,(7.20±1.65)ng/L,(23.53%)].The difference was of statistical significance( P <0.05).Conclus ion Standard large trauma craniotomy in the treatment of STBI could reduce inflammatory response,decrease intracranial pressure and incidence of complications,increasing activity of daily living and improving prognosis.
引文
[1]王克.标准大骨瓣减压术和常规去骨瓣开颅术治疗重型颅脑损伤效果对比分析[J].重庆医学,2017,46(1):355-366.
[2]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.
[3]程松,李多.标准大骨瓣减压术与常规骨瓣开颅术治疗重型颅脑损伤疗效比较[J].实用心脑肺血管病杂志,2016,24(4):310.
[4]陈家祥,李良平,梁一鸣,等.标准大骨瓣减压术治疗重型颅脑损伤的疗效观察[J].中国临床神经外科杂志,2017,22(7):506-507.
[5]韦云锐,孙中波.改良去大骨瓣减压术与标准去骨瓣减压术治疗重型颅脑损伤合并高颅压患者疗效分析[J].山西医药杂志,2017,46(15):1839-1841.
[6]王献明,赵军苍,张莹莹.标准大骨瓣减压术治疗重型颅脑损伤对患者围术期炎性因子、免疫球蛋白、T淋巴细胞亚群和脑代谢的影响[J].河北医药,2017,39(11):1715-1717.
[7]罗安志,黄志敏,王敏.标准大骨瓣减压术对重型颅脑损伤患者术后颅内压及血清PA、MBP水平的影响[J].中国临床研究,2017,30(12):1627-1630.
[8]张晓亮,朱端权,蒋向东.改良切口去大骨瓣减压术在重型颅脑损伤救治中的应用[J].创伤外科杂志,2015,17(4):357.
[9]管峥峰,狄剑秋,杨超,等.标准外伤大骨瓣开颅术治疗重型颅脑损伤的临床效果[J].实用临床医药杂志,2016,20(13):96.
[10]张康,高翔,李文平,等.大骨瓣减压与常规骨瓣减压治疗重型颅脑损伤的对照研究[J].东南国防医药,2015,17(3):256-258.
[11]刘沣,杨华,刘健,等.标准大骨瓣减压术在重型颅脑损伤治疗中的意义[J].贵州医药,2017,41(4):404-405.
[12]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.
[2]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.
[3]程松,李多.标准大骨瓣减压术与常规骨瓣开颅术治疗重型颅脑损伤疗效比较[J].实用心脑肺血管病杂志,2016,24(4):310.
[4]陈家祥,李良平,梁一鸣,等.标准大骨瓣减压术治疗重型颅脑损伤的疗效观察[J].中国临床神经外科杂志,2017,22(7):506-507.
[5]韦云锐,孙中波.改良去大骨瓣减压术与标准去骨瓣减压术治疗重型颅脑损伤合并高颅压患者疗效分析[J].山西医药杂志,2017,46(15):1839-1841.
[6]王献明,赵军苍,张莹莹.标准大骨瓣减压术治疗重型颅脑损伤对患者围术期炎性因子、免疫球蛋白、T淋巴细胞亚群和脑代谢的影响[J].河北医药,2017,39(11):1715-1717.
[7]罗安志,黄志敏,王敏.标准大骨瓣减压术对重型颅脑损伤患者术后颅内压及血清PA、MBP水平的影响[J].中国临床研究,2017,30(12):1627-1630.
[8]张晓亮,朱端权,蒋向东.改良切口去大骨瓣减压术在重型颅脑损伤救治中的应用[J].创伤外科杂志,2015,17(4):357.
[9]管峥峰,狄剑秋,杨超,等.标准外伤大骨瓣开颅术治疗重型颅脑损伤的临床效果[J].实用临床医药杂志,2016,20(13):96.
[10]张康,高翔,李文平,等.大骨瓣减压与常规骨瓣减压治疗重型颅脑损伤的对照研究[J].东南国防医药,2015,17(3):256-258.
[11]刘沣,杨华,刘健,等.标准大骨瓣减压术在重型颅脑损伤治疗中的意义[J].贵州医药,2017,41(4):404-405.
[12]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.