摘要
目的探讨改良阶梯式颅内减压手术治疗重型颅脑损伤致脑疝患者的疗效。方法56例重型颅脑损伤致脑疝患者,随机分为对照组和研究组,每组28例。对照组给予传统标准大骨瓣快速减压手术治疗,研究组给予改良阶梯式颅内减压手术治疗。观察研究组患者节省时间、局部麻醉(局麻)清除部分血肿即可观察散大的瞳孔是否回缩情况,对比两组患者术后6个月预后情况、围手术期并发症发生率。结果研究组患者节省时间为(46.85±0.30)min。研究组患者中,局麻清除部分血肿即可观察散大的瞳孔回缩23例(82.14%),瞳孔未回缩5例(17.86%)。术后6个月,研究组预后良好率为57.14%,高于对照组的28.57%,差异具有统计学意义(P<0.05)。研究组患者术中急性脑膨出发生率为7.14%,低于对照组的39.29%,差异具有统计学意义(P<0.05);研究组迟发性血肿、术后脑梗死发生率分别为3.57%、7.14%,低于对照组的10.71%、10.71%,但差异无统计学意义(P>0.05)。结论重型颅脑损伤致脑疝患者采用改良阶梯式颅内减压手术治疗,其临床疗效明显,值得推广。
Objective To discus the efficacy of modified stepped intracranial decompression surgery in treating patients with cerebral hernia caused by severe craniocerebral injury.Methods A total of 56 patients with cerebral herniation caused by severe craniocerebral injury were randomly divided into control group and research group,with 28 cases in each group.The control group was treated with traditional standard large bone flap rapid decompression surgery,while the research group was treated with modified stepped intracranial decompression surgery.The time saving and whether to observe dilated pupil retraction after partial hematoma removal by local anesthesia in the research group were observed.The prognosis at 6-month after surgery and the perioperative complication rate were compared between the two groups.Results The time saved by the patients in the research group was(46.85±0.30)min.Among the patients in the research group,23 cases(82.14%)of dilated pupil retraction could be observed after partial hematoma removal by local anesthesia,and 5 cases(17.86%)had no pupil retraction.At 6 months after surgery,the good prognosis rate of the research group was 57.14%,which was higher than 28.57%of the control group,and the difference was statistically significant(P<0.05).The incidence of intraoperative acute encephalocele in the research group was 7.14%,which was lower than 39.29%in the control group,and the difference was statistically significant(P<0.05).The incidence rates of delayed hematoma and postoperative cerebral infarction in the research group were 3.57%and 7.14%,which were lower than 10.71%and 10.71%in the control group,but the difference was not statistically significant(P>0.05).Conclusion Modified stepped intracranial decompression surgery has obvious clinical efficacy on patients with cerebral hernia caused by severe craniocerebral injury,and is worthy of promotion.
作者
孙许林
刘杰
宋常华
宫国
岳修臣
SUN Xu-lin;LIU Jie;SONG Chang-hua(Department of Neurosurgery,Gaomi People's Hospital,Weifang 261500,China)
出处
《中国实用医药》
2022年第14期9-12,共4页
China Practical Medicine
关键词
改良阶梯式颅内减压手术
重型颅脑损伤
脑疝
疗效
Modified stepped intracranial decompression surgery
Severe craniocerebral injury
Cerebral hernia
Efficacy
