标准大骨瓣减压术在重型颅外伤所致难治性脑肿胀中的应用及预后脑神经功能的影响

Clinical Effect of Standard Large Bone Flap Decompression in Patients with Refractory Brain Swelling Caused by Severe Craniocerebral Trauma and Its Effect on Prognosis of Patients with Brain Function

目的探究标准大骨瓣减压术对重型颅外伤所致难治性脑肿胀的治疗效果,以及对患者预后脑神经功能的影响。方法选取2016年2月-2017年6月重型颅外伤所致难治性脑肿胀患者88例作为研究对象,按照治疗方法不同进行分组,对照组(n=44)将采取常规颅内压减压术,实验组(n=44)采取标准大骨瓣减压术,两组均行持续监测颅内压监测。观察比较两组的临床疗效,及脑神经功能各项指标的恢复情况。结果历经2-15 h的手术时间后,实验组手术前颅内压从(36.2±6.1)mm Hg降为(16.6±4.3)mm Hg,对照组手术颅内压从(34.6±5.8)mm Hg降为(31.3±3.5)mm Hg,两组差异较大,具有统计学意义(P<0.05);实验组半年后脑功能、神经功能、血压、血糖等指标的恢复率明显强于对照组(P<0.05),其中研究组半年后总恢复情况为91.00(40/44),对照组为50.00(22/44)。结论标准大骨瓣减压术对重型颅外伤所致难治性脑肿胀是一种积极有效降的治疗手段,能使患者预后得以改善,降低致残率与死亡率,具有较高的运用价值。

Objective To study the effect of standard large bone flap decompression on the treatment of refractory brain swelling caused by severe craniocerebral trauma and the effect on the prognosis of patients with brain function.Methods 88 cases of refractory brain swelling caused by severe craniocerebral trauma in our hospital from February to June in 2016 were selected as the subjects. According to the different treatment methods,the control group（ n = 44）Compression group,the experimental group（ n = 44） to take the standard large bone flap decompression,the two groups were under continuous monitoring of intracranial pressure monitoring. To observe the clinical efficacy of the two groups,and the recovery of brain function indicators. Results After 2-15 h operation,the intracranial pressure decreased from（ 36. 2 ± 6. 1） mm Hg to（ 16. 6 ± 4. 3） mm Hg,and the intracranial pressure decreased from（ 34. 6 ± 5. 8） mm Hg to（ 31. 3（ P〈0. 05）. The recovery rate of brain function,neurological function,blood pressure and blood glucose in the experimental group was significantly higher than that in the control group（ P〈0. 05）,and the recovery rate of the two groups was significantly higher than that of the control group（ P〈0. 05） The total recovery was 91. 00（ 40/44） in the study group and 50. 00（ 22/44） in the control group. Conclusions Standard large bone flap decompression is an effective and effective treatment for severe brain swelling caused by severe craniocerebral trauma. It can improve the prognosis and reduce the morbidity and mortality. It has a high value The.