摘要
目的探讨颅内减压手术对重型颅脑损伤(STBI)患者颅内压和神经细胞水平的影响。方法回顾性选取2015年12月至2017年12月我院收治的STBI患者94例,根据治疗方法不同分为对照组和观察组。对照组患者采用常规骨瓣开颅术治疗,观察组患者采用标准大骨瓣减压术治疗,分析两组患者治疗后的临床效果。结果术前,两组患者颅内压、GCS评分水平比较无统计学差异(P>0.05)。术后7 d、14 d时,观察组患者颅内压水平低于对照组,GCS评分高于对照组,差异有统计学意义(P<0.05)。两组患者手术前后脑组织氧摄取率比较无统计学差异(P>0.05)。术前,两组患者hs-CRP、PA、S100β、MBP水平比较无统计学差异(P>0.05);术后7 d,观察组患者hs-CRP、S100β、MBP水平低于对照组,PA水平高于对照组,差异有统计学意义(P<0.05)。术前,两组患者LOTCA评分比较无统计学差异(P>0.05);术后,观察组患者LOTCA评分高于对照组,差异有统计学意义(P<0.05)。观察组患者并发症率低于对照组,差异有统计学意义(χ2=5.595,P=0.018)。结论标准大骨瓣减压手术治疗STBI可改善患者脑功能,降低颅内压水平,提高患者认知功能,保护神经细胞,且并发症少。
Objective To investigate the effect of intracranial decompression on intracranial pressure and nerve cell levels in patients with severe craniocerebral injury （ STBI） . Methods Ninety-four patients with STBI treated between December 2015 and December 2017 were retrospectively selected and divided into the control group and observation group according to treatment methods. The patients in the control group were treated with conventional craniotomy while those in the observation group were treated with standard large bone flap decompression. Results There was no significant difference in GCS score between the two groups before operation （P〉0. 05）. The intracranial pressure in the observation group was significantly lower than that in the control group （P〈0. 05）, and the GCS score was significantly lower than that in the control group at the 14th day after operation （P〈0. 05）. There was no significant difference in oxygen uptake rate between the two groups before and after operation （P〉0. 05）. Before operation, there was no significant difference in MBP levels between the two groups （P〉0. 05）. Seven days after operation, the level of hs-CRPnS100β-MBP in the observation group was lower than that in the control group, but the lev-el of PA was higher （P〈0. 05）. There was no significant difference in the LOTCA score between the two groups before operation （P〉0. 05）. After operation, the LOTCA score in the observation group was higher than that in the control group （P〈0. 05）. The complication rate in the observation group was lower than that in the control group, and the difference was statistically signifi-cant （x2,=5. 595,P=0. 018）. Conclusion The standard large bone flap decompression operation for STBI can improve the brain function of patients , reduce the intracranial pressure, enhance the cognitive function of patients , protect nerve cells , and in-duce fewer complications .
作者
熊洪奇
刘伦鑫
徐建
XIONG Hongqi;LIU Lunxin;XU Jian(Department of Neurosurgery,Jianyang People＇s Hospital,Jianyang Siehuan 641400,China)
出处
《解放军预防医学杂志》
CAS
2018年第5期616-619,共4页
Journal of Preventive Medicine of Chinese People's Liberation Army
基金
四川省自然科学基金项目(No.2016JS0451)
关键词
标准大骨瓣减压术
骨瓣开颅术
重型颅脑损伤
认知功能
standard large trauma craniotomy
bone flap craniotomy
severe craniocerebral injury
cognitive function
