重型颅脑损伤标准大骨瓣开颅术患者围术期炎性应激及代谢状态的变化

Change of inflammatory stress and metabolic status of patients with severe traumatic brain injury during the perioperative period of standard large trauma craniotomy

目的:研究重型颅脑损伤标准大骨瓣开颅术患者围术期炎性应激及代谢状态的变化情况。方法:选取于本院进行手术治疗的58例重型颅脑损伤患者为研究对象,将其根据手术方式的不同分为对照组(常规骨瓣开颅术组)29例和观察组(标准大骨瓣开颅术组)29例,然后将两组术前及术后1、3、5d的脑代谢、蛋白代谢及炎性应激指标进行比较。结果:术前两组脑代谢、蛋白代谢及炎性应激指标比较,差异均无统计学意义(P>0.05);而术后1、3d及5d观察组的脑代谢、蛋白代谢及炎性应激指标均优于对照组,两组术后不同时间比较,差异均具有统计学意义(P<0.05)。结论:重型颅脑损伤标准大骨瓣开颅术患者围术期炎性应激及代谢状态不良波动小于常规骨瓣开颅术,因此标准大骨瓣开颅术更为适用于重型颅脑损伤患者。

Objective:To observe and study the changes of inflammatory stress and metabolic status of patients with severe traumatic brain injury during the perioperative period of undergoing standard large trauma craniotomy.Methods:A total of58 surgical patients with severe traumatic brain injury in our hospital were divided into control group(conventional craniotomy group,n=29cases)and observation group(standard large trauma craniotomy group,n=29cases)by the differences of operation methods,then the cerebral metabolism,proteometabolism and inflammatory stress indexes of two groups before the surgery and at first,third and fifth day after the surgery were compared.Results:The cerebral metabolism,proteometabolism and inflammatory stress indexes of two groups before the surgery all had no significant differences(Pall>0.05),the cerebral metabolism,proteometabolism and inflammatory stress indexes of observation group at first,third and fifth day after the surgery were all better than those of control group(Pall<0.05).Conclusion:The bad fluctuations of inflammatory stress and metabolic status of patients with severe traumatic brain injury during the perioperative period of undergoing standard large trauma craniotomy are smaller than those of conventional craniotomy,so the standard large trauma craniotomy are more suitable for the patients with severe traumatic brain injury.