摘要
目的分析快速开颅技术在外伤性颅内血肿合并脑疝抢救治疗中的临床价值。方法随机选取2012-10—2013-10我院诊治的外伤性颅内血肿合并脑疝患者72例,按照完全抽样法1︰1分成2组,对照组患者行常规血肿清除术,研究组患者行快速开颅血肿清除术,比较2组治疗后近期疗效、血生化指标与生存质量情况。结果研究组患者骨窗完成时间(12.87±5.24)min,较对照组的(27.94±3.78)min短,随访良好率52.78%,对照组30.56%,研究组病死率11.11%,对照组33.33%,2组比较差异均有统计学意义(P<0.01);研究组患者手术后的颅内压、手术第14天与第28天S-100B水平与NDS评分均显著低于对照组(P<0.01),研究组手术第7、14与28天NSE水平均较对照组低(P<0.05)。结论外伤性颅内出血合并脑疝患者开颅清除术前行快速减压法,可缩短完成骨窗时间,减轻神经功能缺损严重程度,改善术后生存质量。
Objective To analyze the clinical application value of rapid craniotomy for the treatment of in traumatic intracranial hematoma combined with hernia.Methods The data were randomly selected from the 72 patients with traumatic intracranial hematoma combined with hernia for treatment in the hospital from October 2012 to October 2013,which were divided into two groups according to the complete sampling.While the 36 cases in the control group underwent conventional hematoma,the 36 patients in the observation group underwent rapid craniotomy.The short-term curative effect,blood biochemical indexes and quality of life after treatment were compared between the two groups.Results The time needed for the completion of bone window in the observation group was（12.87±5.24）min,which was shorter than（27.94±3.78）min in the control group.The rate of goodness during follow-up in the observation group was 52.78%,which was higher than 30.56% in the control group.The mortality rate of the observation group was 11.11%,which was lower than 33.33%in the control group,with a statistical significance（P〈0.01）.Intracranial pressure,S-100 Blevel and NDS score 14 at 28th day after the operation in the study group were significantly lower than those in the control group（P〈0.01）,NSE levels of the patients in the observation group 7,14 and 28days after the operation were all lower than those of the control group（P〈0.05）.Conclusion Rapid decompression in craniotomy for the patients with traumatic intracranial hemorrhage cerebral hernia can shorten the time needed for completion of bone window,reduce the severity of neurological functional defect and improve the quality of life.
出处
《中国实用神经疾病杂志》
2015年第15期7-8,共2页
Chinese Journal of Practical Nervous Diseases
基金
国家自然科学基金项目(81341012)
