急性脑膨出预防策略在重型颅脑外伤患者中的临床应用分析

Analysis of Clinical Application of Acute Encephalocele Prevention Strategy in Patients with Severe Head Injury

目的研究急性脑膨出预防策略在重型颅脑外伤患者中的临床应用。方法方便选取2017年1月—2019年1月该院就诊的重型颅脑外伤患者共50例,随机均分为两组,对照组重型颅脑外伤患者采用常规治疗,观察组重型颅脑外伤患者在常规治疗的基础上实施急性脑膨出预防策略,观察增加急性脑膨出预防策略与采用常规治疗的效果差异。结果观察组患者急性脑膨出总发生率为8.00%,明显低于对照组的28.00%,两组比较差异有统计学意义(χ^2=4.388,P=0.046)。患者术后并发症主要表现为颅内感染、术后脑梗死、迟发性贫血、电解质紊乱、急性肾损害、消化道出血、其他部位感染等,观察组患者术后并发症发生率24.00%明显低于对照组68.00%,差异有统计学意义(χ^2=9.742,P=0.002)。随访1年后,观察组中预后不良者所占比率为44.00%,预后良好者所占比率为56.00%,预后良好率显著高于对照组的28.00%(Z=8.023,P=0.045)。结论在常规治疗的基础上增加急性脑膨出预防策略在治疗重型颅脑外伤方面有较为确切的效果,对减少并发症的发生有明显作用,能够有效缓解症状,减轻对脑组织的损伤。

Objective To study the clinical application of acute encephalocele prevention strategies in patients with severe traumatic brain injury. Methods Convenient selected A total of 50 patients with severe traumatic brain injury who attended the hospital from January 2017 to January 2019 were randomly divided into two groups. The control group received conventional treatment for patients with severe traumatic brain injury. In the observation group, patients with severe traumatic brain injury implemented acute encephalocele prevention strategies on the basis of conventional treatment, and observed the effect of increasing acute encephalocele prevention strategies and conventional treatments. Results The total incidence of acute encephalocele in the observation group was 8.00%, which was significantly lower than the 28.00% in the control group. There was a significant difference between the two groups(χ^2=4.388, P=0.046). Postoperative complications of patients were mainly manifested as intracranial infection, postoperative cerebral infarction, delayed anemia, electrolyte imbalance, acute kidney damage, gastrointestinal hemorrhage, infection of other parts, etc. The postoperative complication ra te of observation group was 24.00%, lower than the control group 68.00%,the difference was statistically significant(χ^2=9.742, P=0.002). After one year of follow-up, the rate of poor prognosis in the observation group was 44.00%, the rate of good prognosis was 56.00%, and the rate of good prognosis was significantly higher than 28.00% in the control group(Z=8.023, P=0.045). Conclusion The addition of acute encephalocele prevention strategies on the basis of conventional treatment has a relatively definite effect in the treatment of severe traumatic brain injury, has a significant effect on reducing the occurrence of complications, can effectively relieve symptoms and reduce brain damage, and it is worthwhile clinical promotion.