摘要
目的 探究控制性阶梯式大骨瓣减压术与快速减压大骨瓣减压术治疗重型颅脑损伤的临床疗效。方法 82例重型颅脑损伤患者为研究对象,依据随机数字表法分为观察组与对照组,各41例。对照组采用快速减压大骨瓣减压术治疗,观察组采用控制性阶梯式大骨瓣减压术治疗。对比两组手术前后不同阶段的颅内压、手术及恢复指标、术后并发症发生情况。结果 术后1、3、7 d,观察组患者的颅内压分别为(22.23±1.68)、(18.18±1.06)、(13.33±1.82)mm Hg(1 mm Hg=0.133 kPa),均明显低于对照组的(29.78±1.77)、(27.20±1.42)、(22.23±1.89)mm Hg,差异有统计学意义(P<0.05)。观察组患者的出血量(102.33±19.20)ml低于对照组的(126.12±22.86)ml,手术时间(1.49±0.33)h及住院时间(13.13±2.20)d短于对照组的(1.86±0.46)h、(15.69±2.51)d,术后2周格拉斯哥昏迷评分(GCS)(11.78±2.18)分高于对照组的(9.68±2.26)分,差异均有统计学意义(P<0.05)。观察组患者术后并发症发生率7.32%低于对照组的24.39%,差异有统计学意义(P<0.05)。结论 与快速减压相比,控制性阶梯式减压能够达到更为理想的降低颅内压的效果,且创伤更小,术后恢复更快,安全性更高。
Objective To investigate the clinical efficacy of controlled stepped decompressive craniectomy and rapid decompressive craniectomy in the treatment of severe craniocerebral injury. Methods A total of 82 patients with severe craniocerebral injury were selected as the research subjects, and were divided into observation group and control group according to the random numerical table, with 41 cases in each group. The control group was treated with rapid decompressive craniectomy, while the observation group was treated with controlled stepped decompressive craniectomy. The intracranial pressure at different stages after surgery, surgery and recovery indicators, and postoperative complications were compared between the two groups. Results At 1, 3,and 7 d after surgery, the intracranial pressures of the observation group were(22.23±1.68),(18.18±1.06), and(13.33±1.82) mm Hg(1 mm Hg=0.133 kPa), which were significantly lower than(29.78±1.77),(27.20±1.42),and(22.23±1.89) mm Hg of the control group, and the differences were statistically significant(P<0.05). The blood loss(102.33±19.20) ml of the observation group was lower than(126.12±22.86) ml of the control group;the operation time(1.49±0.33) h and hospitalization time(13.13±2.20) d of the observation group were shorter than(1.86±0.46) h and(15.69±2.51) d of the control group;the Glasgow coma scale(GCS)(11.78±2.18) points at 2 weeks after surgery of the observation group was higher than(9.68±2.26) points of the control group;all the differences were statistically significant(P<0.05). The postoperative complication rate 7.32% in the observation group was lower than 24.39% in the control group, and the difference was statistically significant(P<0.05).Conclusion Compared with rapid decompression, controlled stepped decompression can achieve a more ideal effect of reducing intracranial pressure, with less trauma, faster postoperative recovery and higher safety.
作者
董陶
DONG Tao(Department of Neurosurgery,Shenyang Red Cross Hospital,Shenyang 110000,China)
出处
《中国实用医药》
2022年第18期58-61,共4页
China Practical Medicine
关键词
重型颅脑损伤
大骨瓣减压术
控制性
阶梯式
快速减压
Severe craniocerebral injury
Decompressive craniectomy
Controlled
Stepped
Rapid decompression
