单纯去骨瓣减压术与联合脑脊液循环重建术治疗重型颅脑损伤的效果对比分析

A Comparative Analysis of the Effect of Decompression by Craniotomy Alone and Cerebrospinal Fluid Circulation Reconstruction in the Treatment of Severe Craniocerebral Injury

目的对比分析重型颅脑损伤(STBI)应用单纯去骨瓣减压术与其联合脑脊液循环重建术治疗的效果。方法选择2016年5月-2019年5月修武县人民医院神经外科收治的STBI患者100例进行分组研究,采取随机数表法分为两组,对照组单用去骨瓣减压术治疗,观察组则加用脑脊液循环重建术治疗。两组均随访3个月以上,记录组间减压完成时间、神经外科滞留时间、随访3个月存活率与GOS评分,并比较。结果观察组减压完成时间明显长于对照组(P <0.05),但观察组神经外科滞留时间更短,随访存活率与GOS评分更高,与对照组差异显著(P <0.05)。结论对于STBI患者而言,采取去骨瓣减压与脑脊液循环重建联合治疗,相比单一去骨瓣减压治疗而言,尽管会延长减压完成时间,但可明显缩短神经外科滞留时间,提高存活率与GOS评分,值得临床应用。

Objective To compare and analyze the effect of craniocerebral injury(STBI) treated by decompression of bone flap alone and cerebrospinal fluid circulation reconstruction. Methods 100 STBI patients admitted to the department of neurosurgery of Xiuwu County People’s Hospital from May 2016 to May 2019 were selected for grouping study, and were divided into two groups by random number table method. Both groups were followed up for more than 3 months, and the completion time of decompression, duration of neurosurgical detention, survival rate for 3 months of follow-up and GOS score were recorded and compared. Results The duration of decompression completion in the observation group was significantly longer than that in the control group(P < 0.05), but the duration of neurosurgical detention was shorter in the observation group, and the survival rate and GOS score of follow-up were higher in the observation group, which was a significant difference from the control group(P < 0.05). Conclusion For STBI patients, combined therapy of decompression with cerebrospinal fluid circulation reconstruction can significantly shorten the duration of neurosurgical detention and improve survival rate and GOS score, although the decompression time will be prolonged compared with single decompression with craniotomy, which is worthy of clinical application.