经天幕裂孔切开联合标准大骨瓣减压术治疗颅脑损伤患者的临床效果

Clinical effect of tentorium cerebelli hiatus incision combined with standard large trauma craniotomy in the treatment of patients with craniocerebral injury

目的探讨经天幕裂孔切开联合标准大骨瓣减压术治疗颅脑损伤患者的临床效果.方法将我院2014年10月至2018年10月收治的50例颅脑损伤患者以数字表法随机分为对照组和观察组,每组25例.对照组采用标准大骨瓣减压术治疗,观察组采用经天幕裂孔切开联合标准大骨瓣减压术治疗.比较两组的治疗效果.结果术前,两组颅内压比较,差异无统计学意义(P>0.05);术后7 d,观察组颅内压显著低于对照组(P<0.05).术后7 d,两组血清和脑脊液中t-PA、PAI-1水平均降低,且观察组显著低于对照组(P<0.05).术后3个月,观察组预后良好率为76.00%,显著高于对照组的48.00%,差异有统计学意义(P<0.05).结论临床治疗颅脑损伤采用经天幕裂孔切开联合标准大骨瓣减压术能够有效降低患者颅内压,改善t-PA、PAI-1水平,提高预后效果,值得推广.

Objective To explore the clinical effect of tentorium cerebelli hiatus incision combined with standard large trauma craniotomy in the treatment of patients with craniocerebral injury. Methods Fifty patients with craniocerebral injury admitted in our hospital from October 2014 to October 2018 were divided into control group and observation group by random number table method, with 25 cases in each group. The control group was treated with standard large trauma craniotomy, and the observation group was treated with tentorium cerebelli hiatus incision combined with standard large trauma craniotomy. The therapeutic effects of the two groups were compared. Results There was no significant difference in intracranial pressure between the two groups before operation(P>0.05);at the 7 th day after operation, the intracranial pressure in the observation group was significantly lower than that in the control group(P <0.05). At the 7 th day after operation, the levels of t-PA and PAI-1 in serum and cerebrospinal fluid in both groups decreased, and those in the observation group were significantly lower than the control group(P<0.05). At 3 months after operation, the good rate of prognosis in the observation group was 76.00%, which was significantly higher than 48.00% in the control group, the difference was statistically significant(P<0.05). Conclusion Tentorium cerebelli hiatus incision combined with standard large trauma craniotomy in the treatment of craniocerebral injury can effectively reduce the intracranial pressure, improve the levels of t-PA and PAI-1 and the prognosis of patients. It is worth popularizing.