摘要
目的探讨控制性减压术在额叶脑挫裂伤患者骨瓣开颅清除血肿术中的应用效果。方法78例额叶脑挫裂伤患者,以简单随机化法分为对照组(39例,给予常规骨瓣开颅清除血肿术)和研究组(39例,采用控制性减压术结合骨瓣开颅清除血肿术)。比较两组患者颅内压、意识状态[格拉斯哥昏迷评分(GCS)]、预后情况及并发症发生率。结果对照组术前、术后1 d、术后5 d的颅内压分别为(26.69±5.33)、(23.51±4.68)、(19.51±3.87)mm Hg(1 mm Hg=0.133 kPa),研究组分别为(27.54±5.49)、(21.36±4.27)、(15.42±3.06)mm Hg。与术前比较,两组术后1、5 d的颅内压均降低,且研究组低于对照组,有统计学差异(P<0.05);与术后1 d比较,两组术后5 d的颅内压均降低,有统计学差异(P<0.05)。与术前比较,两组术后1 d、3个月的GCS评分均上升,且研究组高于对照组,有统计学差异(P<0.05);与术后1 d比较,两组术后3个月的GCS评分均升高,有统计学差异(P<0.05)。研究组预后良好率(89.74%)高于对照组(71.79%),有统计学差异(χ^(2)=4.044,P=0.044<0.05)。两组术后并发症发生率无统计学差异(χ^(2)=0.214,P=0.644>0.05)。结论控制性减压术在额叶脑挫裂伤患者骨瓣开颅清除血肿术中的应用效果显著,可降低术后颅内压,改善患者意识状态及预后。
Objective To explore the application effect of controlled decompression in craniotomy for hematoma removal in patients with frontal lobe contusion.Methods A total of 78 patients with frontal lobe contusion were divided into control group(39 cases,conventional craniotomy for hematoma removal)and study group(39 cases,controlled decompression combined with craniotomy for hematoma removal)by simple randomization.The intracranial pressure,state of consciousness[Glasgow Coma Score(GCS)],prognosis and incidence of complications were compared between the two groups.Results In the control group,the intracranial pressure before surgery,1 d and 5 d after surgery were(26.69±5.33),(23.51±4.68)and(19.51±3.87)mm Hg(1 mm Hg=0.133 kPa),and those in the study groups were(27.54±5.49),(21.36±4.27),and(15.42±3.06)mm Hg.Compared with before surgery,the intracranial pressure in both groups decreased at 1 d and 5 d after surgery,and the study group was lower than the control group.There was statistical difference P<0.05). Compared with 1 d after surgery, the intracranial pressure in both groups decreased at 5 d after surgery, and there was statistical difference (P<0.05). Compared with before surgery, GCS scores in both groups increased at 1 d and 3 months after surgery, and the study group was higher than the control group, and there was statistical difference (P<0.05). Compared with 1 d after surgery, GCS scores in both groups were increased at 3 months after surgery, and there was statistical difference (P<0.05). The good prognosis rate of the study group (89.74%) was higher than that of the control group (71.79%), and there was statistical difference (χ^(2)=4.044, P=0.044 < 0.05). There was no significant difference in the incidence of postoperative complications between the two groups (χ^(2)=0.214, P=0.644 > 0.05). Conclusion The application of controlled decompression in craniotomy for hematoma removal in patients with frontal lobe contusion is remarkable, which can reduce the intracranial pressure and improve the patient's consciousness and prognosis.
作者
杨健炳
YANG Jian-bing(Department of Neurosurgery,Xiapu County Hospital,Ningde 355100,China)
出处
《中国现代药物应用》
2025年第6期47-50,共4页
Chinese Journal of Modern Drug Application
关键词
额叶脑挫裂伤
控制性减压术
骨瓣开颅清除血肿术
预后
Frontal lobe contusion
Controlled decompression
Craniotomy for hematoma removal
Prognosis
