摘要
目的:探讨脑出血去骨瓣减压术后择期行颅骨修补的效果。方法:选取2021年1月—2023年6月南昌大学第四附属医院收治的86例行脑出血去骨瓣减压术并择期行颅骨修补的患者,按照修补时间实施分组处理,对照组43例在去骨瓣减压术后3~6个月实施颅骨修补治疗,观察组43例在去骨瓣减压术后≥1个月且<3个月实施颅骨修补治疗。比较两组临床疗效、临床指标、并发症发生率、疼痛程度、颅脑指标、应激指标。结果:观察组总有效率高于对照组(P<0.05);观察组术后6个月NIHSS评分、mRS评分均低于对照组,GOS评分、MMSE评分均高于对照组(P<0.05);观察组并发症发生率低于对照组(P<0.05);观察组术后3、5、7 d头痛VAS评分均低于对照组(P<0.05);观察组术后24 h颅内压异常指数、脑灌注异常指数均低于对照组(P<0.05);观察组术后24 h皮质醇、IL-6、TNF-α均低于对照组(P<0.05)。结论:在脑出血去骨瓣减压术后≥1个月且<3个月实施颅骨修补治疗,可降低机体应激反应,同时改善颅脑指标及预后效果。
Objective:To investigate the effect of cranial repair after decompressive craniectomy.Method:A total of 86 patients with intracerebral hemorrhage undergoing decompressive craniectomy and skull repair were selected from the Fourth Affiliated Hospital of Nanchang University from January 2021 to June 2023.According to the repair time,43 cases in the control group received skull repair at 3-6 months after decompressive craniotomy,and 43 cases in the observation group received skull repair at≥1 month and<3 months after decompressive craniotomy.The clinical efficacy,clinical indexes,complication rate,pain degree,craniocerebral indexes and stress indexes were compared between the two groups.Result:The total effective rate of observation group was higher than that of control group(P<0.05).6 months after operation,NIHSS score and mRS score in observation group were lower than those in control group,GOS score and MMSE score were higher than those in control group(P<0.05).The complication rate of observation group was lower than that of control group(P<0.05).The headache VAS scores of the observation group at 3,5 and 7 days after operation were lower than those of the control group(P<0.05).The abnormal index of intracranial pressure and cerebral perfusion at 24 h after operation in the observation group were lower than those in the control group(P<0.05).The levels of cortisol,IL-6 and TNF-αin observation group were lower than those in control group 24 h after operation(P<0.05).Conclusion:Skull repair at≥1 month and<3 months after decompressive craniectomy for intracerebral hemorrhage can reduce the stress response of the body,and improve the craniocerebral indicators and prognosis.
作者
曾斌华
万辉
王新刚
ZENG Binhua;WAN Hui;WANG Xingang(Department of Neurosurgery,the Fourth Affiliated Hospital of Nanchang University,Nanchang 330003,China;不详)
出处
《中国医学创新》
CAS
2024年第32期1-5,共5页
Medical Innovation of China
关键词
脑出血
去骨瓣减压术
颅骨修补
颅脑指标
应激指标
Intracerebral hemorrhage
Decompressive craniectomy
Skull repair
Brain indicators
Stress index
