标准去大骨瓣颅内减压术对急性硬膜下血肿患者血清NSE、IL-6及颅内压的影响

Effect of Standard Large Trauma Craniotomy on Serum NSE,IL-6 and Intracranial Pressure in Patients with Acute Subdural Hematoma

目的探讨标准去大骨瓣颅内减压术对急性硬膜下血肿患者血清神经元特异性烯醇化酶(NSE)、白细胞介素-6(IL-6)及颅内压的影响。方法回顾性分析2018年1月至2019年6月宿迁市中医院收治的急性硬膜下血肿患者40例,按手术方式不同分成对照组与观察组,各20例。对照组行常规骨瓣开颅手术,观察组行标准去大骨瓣颅内减压手术。比较2组术前与术后14 d的血清NSE、IL-6水平;比较2组术前及术后1 d、3 d、5 d、7 d的颅内压情况;比较2组术后并发症发生情况。结果与术前相比,术后14 d 2组血清NSE、IL-6水平均降低,且观察组低于对照组(P<0.05)。与术前相比,术后1~7 d 2组颅内压逐渐降低,且观察组低于对照组(P<0.05)。术后,观察组并发症总发生率5.00%低于对照组30.00%,差异无统计学意义(P>0.05)。结论标准去大骨瓣颅内减压手术可降低急性硬膜下血肿患者血清NSE、IL-6水平与颅内压,且并发症较少。

Objective To investigate the effect of of standard large trauma craniotomy on serum NSE,IL-6 and intracranial pressure in patients with acute subdural hematoma.Methods Totally 40 patients with acute subdural hematoma admitted to suqian hospital of traditional Chinese medicine from January 2018 to June 2019 were retrospectively analyzed.They were divided into control group and observation group according to different surgical methods,with 20 cases each.The control group received conventional craniotomy and the observation group received standard craniotomy.Serum NSE and il-6 levels of the 2 groups were compared before and 14 days after surgery.The intracranial pressure before and after 1,3,5 and 7 days were compared between the two groups.The incidence of postoperative complications was compared between the two groups.Results Compared with before operation,serum NSE and IL-6 levels of two groups were decreased 14 days after the operation,and the observation group was lower than the control group(P<0.05).Compared with before operation,the intracranial pressure in the two groups decreased gradually from 1 to 7 days after the operation,and the observation group was lower than the control group(P<0.05).After surgery,the total incidence of complications in the observation group(5.00%)was lower than that in the control group(30.00%),but the difference was not statistically significant(P>0.05).Conclusion The standard large trauma craniotomy can reduce the serum NSE,IL-6 levels and intracranial pressure in patients with acute subdural hematoma,and has fewer complications.