阶梯式颅内减压技术在急性重度颅脑损伤治疗中的应用价值

Application Value of Stepped Intracranial Decompression in the Treatment of Acute Severe Craniocerebral Injury

目的研究阶梯式颅内减压技术在急性重度颅脑损伤治疗中的应用价值。方法选取2019年3月-2021年3月来我院诊治的60例急性重度颅脑损伤患者为研究对象,采用随机数字表法分为对照组和观察组,各30例。对照组采用常规减压术治疗,观察组采用阶梯式颅内减压技术治疗,比较两组临床手术指标、格拉斯哥昏迷(GCS)评分、并发症发生率以及预后效果。结果观察组手术时间、术中出血量均小于对照组,差异有统计学意义(P<0.05);观察组GCS评分为(17.45±2.98)分,高于对照组的(12.90±3.14)分,差异有统计学意义(P<0.05);观察组并发症总发生率低于对照组,但差异无统计学意义(P>0.05)。观察组预后良好、中残占比均高于对照组,重残、植物状态以及死亡占比低于对照组,差异有统计学意义(P<0.05)。结论阶梯式颅内减压技术可缩短急性重度颅脑损伤患者手术时间,减少术中出血量,降低术后并发症发生率,改善脑损伤程度及预后效果,对提高急性重型颅脑损伤的救治效果具有重要的临床意义。

Objective To study the application value of stepped intracranial decompression in the treatment of acute severe craniocerebral injury.Methods Sixty patients with acute severe craniocerebral injury diagnosed and treated in our hospital from March 2019 to March 2021 were selected as the research objects.They were divided into control group and observation group by random number table method,with 30 cases in each group.The control group was treated with conventional decompression,and the observation group was treated with stepped intracranial decompression.The clinical operation indexes,Glasgow coma score(GCS),incidence of complications and prognosis of the two groups were compared.Results The operation time and intraoperative blood loss of the observation group were less than those of the control group,and the difference was statistically significant(P<0.05).The GCS score of the observation group was(17.45±2.98)scores,which was higher than(12.90±3.14)scores of the control group,and the difference was statistically significant(P<0.05).The total incidence of complications in the observation group was lower than that in the control group,but the difference was not statistically significant(P>0.05).The proportion of good prognosis and moderate disability in the observation group was higher than that in the control group,while the proportion of severe disability,plant status and death in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Stepped intracranial decompression technology can shorten the operation time of patients with acute severe craniocerebral injury,reduce intraoperative blood loss,reduce the incidence of postoperative complications,improve the degree of brain injury and prognosis,and has important clinical significance for improving the treatment effect of acute severe craniocerebral injury.