标准外伤大骨瓣开颅术对重型颅脑损伤患者颅内压力变化情况、神经功能缺损情况的影响OA
Effect of Standard Large Trauma Craniotomy on Intracranial Pressure Changes and Neurological Deficits in Patients with Severe Craniocerebral Injury
目的 探讨标准外伤大骨瓣开颅术对重型颅脑损伤患者颅内压力变化情况、神经功能缺损情况的影响.方法 从天津市蓟州区人民医院 2022 年 6 月-2024 年 5 月收治的重型颅脑损伤患者中,选取 120 例作为研究对象.运用随机数字表法将其划分为对照组和研究组,每组 60 例.对照组行常规骨瓣开颅术,研究组行标准外伤大骨瓣开颅术.对两组临床疗效、颅内压力变化情况、神经功能缺损情况及术后并发症发生情况(切口脑脊液漏、癫痫、切口疝、颅内感染、术后再出血)进行比较.结果 研究组优良率为 95.00%,对照组优良率为 78.33%,组间比较,差异有统计学意义(P＜0.05);两组术后 2、4、6 d的ICP均低于术前,且与对照组相比,研究组术后 2、4、6 d的ICP更低(P＜0.05);两组术后 1 周、1 个月NIHSS评分均低于术前,且与对照组相比,研究组术后 1 周、1 个月NIHSS评分更低(P＜0.05);研究组术后并发症发生率(1.67%)低于对照组(15.00%)(P＜0.05).结论 标准外伤大骨瓣开颅术在重型颅脑损伤患者中的应用效果确切,能够降低患者颅内压力,改善患者神经功能,保护患者脑组织,且安全性较高.
Objective To investigate the effect of standard large trauma craniotomy on intracranial pressure changes and neurological deficits in patients with severe craniocerebral injury.Methods Totally 120 patients with severe craniocerebral injury,who were admitted to Jizhou District People's Hospital of Tianjin from June 2022 to May 2024,were selected as the research objects.According to the random number table method,the subjects were divided into control group and study group,with 60 patients in each group.The control group underwent conventional bone flap craniotomy,and the study group underwent standard traumatic large bone flap craniotomy.The clinical efficacy,intracranial pressure changes,neurological deficits and postoperative complications(incisional cerebrospinal fluid leakage,epilepsy,incisional hernia,intracranial infection,postoperative rebleeding)were compared between the two groups.Results A statistically significant difference was observed in the excellent and good rates between the two groups,with the study group demonstrating a markedly higher rate of 95.00%compared to 78.33%in the control group(P<0.05).The ICP of the two groups at 2,4 and 6 days after operation were lower than those before operation,and the ICP in the study group remained significantly lower than that in the control group at 2,4,and 6 days after operation(P<0.05).Both groups showed significant decreased in NIHSS score at 1 week and 1 month after operation compared with their before operation,with the study group demonstrating significantly lower NIHSS score than the control group at 1 week and 1 month after operation(P<0.05).A statistically significant difference was found in the incidence of postoperative complications between the two groups,with the study group demonstrating a markedly lower rate of 1.67%compared to 15.00%in the control group(P<0.05).Conclusion Standard large trauma craniotomy is effective in patients with severe craniocerebral injury,which can reduce intracranial pressure,improve neurological function,protect brain tissue and has high safety.
李思辰;王涛;孙学武
天津市蓟州区人民医院神经外科,天津 301900天津市蓟州区人民医院神经外科,天津 301900天津市蓟州区人民医院神经外科,天津 301900
医药卫生
标准外伤大骨瓣开颅术重型颅脑损伤颅内压力脑组织
Standard large trauma craniotomySevere craniocerebral injuryIntracranial pressureBrain tissue
《医学信息》 2026 (6)
129-132,4
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