控制性减压术防治老年重型颅脑损伤患者并发脑梗死的疗效分析

Control Effect Analysis of Patients with Cerebral Infarction and Decompression in Prevention and Treatment of Severe Craniocerebral Injury in Elderly

目的研究并探讨控制性减压术防治老年重型颅脑损伤患者并发脑梗死的临床效果。方法于2013年1月—2015年6月选取100例老年重型颅脑损伤患者作为此次研究的对象,采取抛掷硬币的随机分组方法将这100例患者分为对照组、观察组,每组均分有患者50例。对照组进行标准大骨瓣减压术治疗,观察组进行控制性减压术治疗。对比两组患者的颅内压、脑梗死发生率、Barthel指数和GOS指数。结果手术后观察组的颅内压为(125.45±5.03)mmH_2O,明显低于对照组的(133.21±7.12)mmH_2O(P<0.05)。观察组的脑梗死发生率为6%,明显低于对照组的22%(P<0.05)。观察组的Barthel指数和GOS指数分别为(74.46±4.79)分、(4.18±0.94)分,明显高于对照组的(67.35±3.56)分、(2.93±0.82)分(P<0.05)。结论采用控制性减压术治疗老年重型颅脑损伤患者,可有效降低颅内压,减少脑梗死的发生,改善预后。

Objective To study and explore the clinical effect of damage control in patients with cerebral infarction and decompression in treatment of senile severe craniocerebral. Methods In January 2013-June 2015, a total of 100 cases of elderly patients with severe craniocerebral injury were selected as the research object, the 100 patients were taken a coin toss randomly and divided into the control group and the observation group, each group had 50 patients. The patients of the control group were treated with standard large trauma craniotomy, the patients of the observation group were treate with controlling decompression surgery. The intracranial pressure, incidence of cerebral infarction, Barthel index and GOS index were compared with the patients of two groups. Results After operation, the intracranial pressure of the observation group was（125.45 ± 5.03） mmH2O, which was significantly lower than that of the control group of（133.21 ± 7.12） mmH2O（P〈0.05）. The incidence rate of cerebral infarction in the observation group was 6%, which was significantly lower than that of the control group of 22%（P〈0.05）. The Barthel index and GOS index in the observation group were（74.46 ± 4.79） points,（4.18±0.94） points, were significantly higher than the control group of（67.35 ± 3.56） points,（2.93 ± 0.82） points（P〈0.05）.Conclusion The control of decompression in the treatment of elderly patients with severe traumatic brain injury, can effectively reduce intracranial pressure, reduce the incidence of cerebral infarction and improve the prognosis.