摘要
目的:探讨标准外伤大骨瓣开颅术联合亚低温对重型颅脑损伤患者术后NIHSS评分及血清星形胶质源性蛋白(S-100β)、髓鞘碱性蛋白(MBP)水平的影响。方法:选取2016年4月至2017年11月东营市第二人民医院神经外科收治重型颅脑损伤患者72例,随机数字表法分为对照组(n=36)与研究组(n=36)。对照组采用标准外伤大骨瓣开颅术,研究组采用标准外伤大骨瓣开颅术+亚低温治疗。入院时及术后1个月统计对比两组神经功能缺损评分(NIHSS)、术前及术后不同时间段(1d、2d、3d)颅内压水平、入院时及术后第1d血清S-100β及MBP水平变化情况,并统计对比两组并发症发生率。结果:治疗后两组NIHSS分值较治疗前降低,且研究组较对照组低,差异有统计学意义(P<0.05);治疗后1d、2d、3d两组颅内压较治疗前降低,且各时间段研究组颅内压较对照组低,差异有统计学意义(P<0.05);治疗后两组血清S-100β及MBP水平较治疗前降低,且研究组较对照组低,差异有统计学意义(P<0.05);两组并发症发生率比较,研究组较对照组低,差异有统计学意义(P<0.05)。结论:联合采用标准外伤大骨瓣开颅术及亚低温治疗重型颅脑损伤效果显著,可有效降低颅内压,改善患者神经功能,降低血清S-100β、MBP水平,且并发症发生率较低,具有安全性,值得推广。
Objective： To investigate the effects of standard large trauma craniotomy combined with mild hypothermia on postoperative NIHSS score and serum astrocyte protein（S-100β） and myelin basic protein（MBP） in patients with severe craniocerebral injury. Methods： From April 2016 to November 2017,72 patients with severe craniocerebral injury were treated in the Department of Neurosurgery at the second people＇s Hospital in Dongying. The random digital table method was divided into the control group（n = 36） and the study group（n = 36）. The control group was treated with standard large trauma craniotomy,while the study group was treated with standard large trauma craniotomy plus mild hypothermia treatment. 1 month after admission and 1 month after operation,the scores of two groups of nerve function defect（NIHSS）,intracranial pressure level（1 d,2 d,3 d）,and the changes of serum S-100 beta and MBP levels at admission and first d after operation were compared,and the incidence of complications in two groups were compared. Results： The NIHSS scores in the two groups after treatment were lower than those before treatment,and the study group was lower than the control group,the difference was statistically significant（P 0.05）; The intracranial pressure of the two groups at 1 d,2 d and 3 d after treatment was lower than before treatment,and the study group was lower than that of the control group at each time period,the difference was statistically significant（P 0.05）; The levels of serum S-100β and MBP in the two groups after treatment were lower than those before treatment,the study group was lower than the control group,the difference was statistically significant（P 0.05）; The incidence of complications in the study group was significantly lower than that of the control group（P 0.05）. Conclusion： Treatment of severe craniocerebral injury using standard large trauma craniotomy combined with mild hypothermia gets a significant effect,which can effectively reduce intracranial pressure,improve neurological function,reduce serum S-100β,MBP levels,and the low incidence of complications,with higher security,worthy of promotion.
作者
冯涛
韩兵
叶凯华
FENG Tao;HAN Bing;YE Kaihua(The Second People＇s Hospital of Dongying,Shandong Dongying 257335,China)
出处
《河北医学》
CAS
2018年第8期1325-1328,共4页
Hebei Medicine
基金
山东省医药卫生科技发展计划项目
(编号:2015WS0126)
关键词
标准外伤大骨瓣开颅术
亚低温
重型颅脑损伤
Standard large trauma eraniotomy
Miht hypothermia
Severe eranioeerebral injury
