摘要
目的:观察去骨瓣减压联合着力部位硬膜外血肿清除治疗对冲性重症颅脑损伤的临床效果。方法:选取福建省福清市医院2020年1月—2023年2月收治的216例对冲性重症颅脑损伤患者,按照随机数字表法分为研究组和对照组,各108例。对照组采用去骨瓣减压联合常规开颅血肿清除治疗,研究组采用去骨瓣减压联合着力部位硬膜外血肿清除治疗。对比两组临床症状、预后、意识状态、术后并发症、创伤应激反应。结果:研究组预后良好率和术后7 d格拉斯哥昏迷量表(GCS)评分均高于对照组,术后7 d对侧血肿厚度及中线移位均小于对照组,术后7 d颅内压、术后并发症发生率及术后7 d肾上腺素(E)、β-内啡肽(β-EP)、皮质醇(Cor)水平均低于对照组(P<0.05)。结论:去骨瓣减压联合着力部位硬膜外血肿清除治疗对冲性重症颅脑损伤效果显著,不仅能够清除患者脑血肿,降低颅内压,减轻中线移位和创伤应激,还可改善患者意识状态,减少术后并发症发生,改善预后。
Objective:To observe the clinical effect of decompressive craniectomy combined with evacuation of epidural hematoma at the focus area in the treatment of contrecoup severe traumatic brain injury.Method:A total of 216 patients with contrecoup severe traumatic brain injury treated in Fuqing City Hospital,Fujian Province from January 2020 to February 2023 were selected and divided into study group and control group according to random number table method,with 108 cases in each group.The control group was treated with decompressive craniectomy combined with conventional craniotomy evacuation of hematoma,and the study group was treated with decompressive craniectomy combined with evacuation of epidural hematoma at the focus area.The clinical symptoms,prognosis,conscious state,postoperative complications and traumatic stress reaction were compared between the two groups.Result:The good prognosis rate and Glasgow coma scale(GCS)scores at 7 days after surgery in the study group were higher than those in the control group,the hematoma thickness and midline displacement at 7 days after surgery were lower than those in the control group,the intracranial pressure at 7 days after surgery,the incidence of postoperative complications,and the levels of adrenaline(E),β-endorphin(β-EP)and cortisol(Cor)at 7 days after surgery were lower than those of control group(P<0.05).Conclusion:Decompressive craniectomy combined with evacuation of epidural hematoma at the focus area has a significant effect in the treatment of contrecoup severe traumatic brain injury,which can not only remove cerebral hematoma,reduce intracranial pressure,relieve midline displacement and traumatic stress,but also improve patients'conscious state,reduce postoperative complications,and improve prognosis.
作者
林小弟
王亚亮
杜辉标
LIN Xiaodi;WANG Yaliang;DU Huibiao(Department of Neurosurgery,Fuqing City Hospital,Fujian Province,Fuqing 350300,China;不详)
出处
《中国医学创新》
CAS
2024年第16期44-48,共5页
Medical Innovation of China
关键词
去骨瓣减压
着力部位硬膜外血肿清除
对冲性重症颅脑损伤
创伤应激
颅内压
Decompressive craniectomy
Evacuation of epidural hematoma at the focus area
Contrecoup severe traumatic brain injury
Traumatic stress
Intracranial pressure
