标准大骨瓣开颅减压手术联合尿激酶灌注治疗重型颅脑损伤患者的应用效果

Effect of Standard Large Craniotomy combined with urokinase Perfusion in the Treatment of Patients with severe craniocerebral Injury

目的分析标准大骨瓣开颅减压手术联合尿激酶灌注治疗对重型颅脑损伤患者的治疗效果。方法回顾性分析河南神火集团职工总医院2016年1月至2020年3月收治的118例重型颅脑损伤患者临床资料,按手术方式不同分为观察组(n=58)和对照组(n=60)。观察组给予标准大骨瓣开颅减压术+术后尿激酶灌注治疗,对照组给予常规骨瓣开颅减压术治疗,观察两组患者手术效果和康复效果指标。结果治疗后,两组患者血肿量和颅内压均显著低于治疗前,且观察组显著低于对照组(P<0.05)。观察组住院时间显著低于对照组(P<0.05)。治疗前,两组患者NIHSS评分无显著性差异(P>0.05);治疗后,观察组患者NIHSS评分显著低于对照组(P<0.05)。结论标准大骨瓣开颅减压手术联合尿激酶灌注治疗重型颅脑损伤患者疗效明显,可根据患者损伤程度综合选择。

Objective To analyze the effect of standard large craniotomy combined with urokinase perfusion in the treatment of patients with severe craniocerebral injury.Methods The clinical data of 118 patients with severe craniocerebral injury admitted to the General Hospital of Henan Shenhuo Group from January 2016 to March 2020 were analyzed retrospectively.The patients were divided into observation group(N=58)and control group(N=60)according to different operation methods.The observation group was treated with standard large bone flap craniotomy combined with postoperative urokinase perfusion,and the control group was treated with routine craniotomy.The operative and rehabilitative effects of the two groups were observed.Results After treatment,the hematoma volume and intracranial pressure in the two groups were significantly lower than those before treatment,and the observation group was significantly lower than the control group(P<0.05).The duration of hospitalization in the observation group was significantly lower than that in the control group(P<0.05).There was no significant difference in NIHSS score between the two groups before treatment(P>0.05),and the NIHSS score in the observation group was significantly lower than that in the control group after treatment(P<0.05).Conclusion Standard large bone flap craniotomy combined with urokinase perfusion in the treatment of severe craniocerebral injury in patients with obvious effect,according to the degree of injury in patients with comprehensive choice.