摘要
目的探析重型颅脑损伤手术患者采用控制性阶梯式减压的临床效果。方法方便选择2018年1月—2020年1月北京市红十字会急诊抢救中心130例重型颅脑损伤患者,根据病情必须行单侧额颞顶去骨瓣减压手术者,随机分成两组。对照组采用传统单侧标准大骨瓣减压,试验组采用控制性阶梯式单侧标准大骨瓣减压。对比两组临床指标、并发症和临床预后。结果试验组手术时间为(90.24±8.13)min、术中出血量为(105.02±3.61)mL、术后2周ICP水平为(192.30±11.19)mmH2O,对照组手术时间为(122.00±9.02)min、术中出血量为(129.61±3.99)mL、术后2周ICP水平为(218.55±10.14)mmH2O比较,差异有统计学意义(t=21.086、36.845、14.015,P<0.05);试验组术后并发症(脑膨出、迟发颅内出血、脑梗死)总体发生率6.15%低于对照组18.46%,差异有统计学意义(χ^(2)=4.561,P<0.05);试验组存活率98.46%高于对照组87.69%,差异有统计学意义(χ^(2)=4.398,P<0.05)。结论控制性阶梯式减压术运用在重型颅脑损伤患者中疗效理想,能减少一些相关并发症、改善临床预后,临床推广价值高。
Objective To analyze the clinical effect of controlled stepped decompression in patients with severe head injury surgery.Methods From January 2018 to January 2020,130 patients with severe craniocerebral injury in the emergency rescue center of the Beijing Red Cross Society were convenient selected,and those who had to undergo unilateral frontotemporal craniectomy decompression were randomly divided into two groups according to their condition.The control group used traditional unilateral standard large bone flap decompression,and the test group used controlled stepped unilateral standard large bone flap decompression.The clinical indicators,complications and clinical prognosis of the two groups were compared.Results The operation time of the experimental group was(90.24±8.13)min,the intraoperative blood loss was(105.02±3.61)mL,the ICP level was(192.30±11.19)mmH2O2 weeks after the operation,and the operation time of the control group was(122.00±9.02)min The intraoperative blood loss was(129.61±3.99)mL,and the ICP level was(218.55±10.14)mmH2O2 weeks after the operation.The difference was statistically significant(t=21.086,36.845,14.015,P<0.05);The overall incidence of post-complications(encephalocele,delayed intracranial hemorrhage,cerebral infarction)was 6.15%lower than the control group 18.46%,the difference was statistically significant(χ^(2)=4.561,P<0.05);the survival rate of the experimental group was 98.46%higher in the control group 87.69%,the difference was statistically significant(χ^(2)=4.398,P<0.05).Conclusion Controlled stepwise decompression is effective in patients with severe head injury.It can reduce some related complications,improve clinical prognosis,and has high clinical promotion value.
作者
张敏
徐珑
马大程
张银善
郭宗培
ZHANG Min;XU Long;MA Da-cheng;ZHANG Yin-shan;GUO Zong-pei(Department of Neurosurgery,Beijing Red Cross Emergency Rescue Center,Beijing,100192 China;Department of Neurosurgery,Beijing Tiantan Hospital,Capital Medical University,Beijing,100070 China)
出处
《中外医疗》
2021年第8期66-68,共3页
China & Foreign Medical Treatment
关键词
治疗效果
阶梯式减压术
并发症
重型颅脑损伤
Treatment effect
Stepped decompression
Complications
Severe head injury
