标准外伤大骨瓣开颅术在重型颅脑损伤治疗中的临床应用

Clinical Application of Standard Trauma Craniotomy with Large Bone Flap in the Treatment of Severe Head Injury

目的对标准外伤大骨瓣开颅术在重型颅脑损伤患者临床治疗中的应用效果进行分析,并探讨其临床价值。方法方便选取2018年1月—2020年12月期间在该院开展临床治疗的66例重型颅脑损伤患者,采用单盲法分组,各33例,参照组进行常规开颅手术治疗,观察组进行标准外伤大骨瓣开颅术治疗,对比两组患者临床治疗情况。结果观察组患者IL-2、TNF-α、GCS评分以及NIHSS评分分别为(21.49±2.35)ng/L、(20.18±5.87)ng/L、(12.95±1.72)分、(12.34±2.35)分,治疗后1 d与7 d两个时间段的颅内压水平分别为(24.98±2.17)、(16.89±1.46)mmHg,优于参照组,差异有统计学意义(t=16.868、7.176、7.597、13.715、7.471、17.843,P<0.001);观察组患者不良反应发生率为12.1%,显著低于参照组,差异有统计学意义(χ^(2)=5.280,P=0.021)。结论应用标准外伤大骨瓣开颅术方式对重型颅脑损伤患者施以治疗,可改善患者炎症因子水平和神经功能,对患者临床治疗效果的提升具有积极意义。

Objective To analyze the effect of standard trauma craniotomy in the clinical treatment of patients with severe head injury,and to explore its clinical value.Methods 66 patients with severe head injury who had undergone clinical treatment in the hospital from January 2018 to December 2020 were conveniently selected.Grouped by the single-blind method method,with 33 cases in each group,the reference group was treated with conventional craniotomy,and the observation group was treated with standard trauma craniotomy with large boin flab.Compared the clinical treatment of the two groups of patients.Results The IL-2,TNF-α,GCS scores and NIHSS scores of the observation group were(21.49±2.35)ng/L,(20.18±5.87)ng/L,(12.95±1.72)points,(12.34±2.35)points,respectively,the intracranial pressure levels at 1 d and 7 d after treatment(24.98±2.17)mmHg and(16.89±1.46)mmHg,respectively,were better than the reference group,the difference was statistically significant(t=16.868,7.176,7.597,13.715,7.471,17.843,P<0.001).The incidence of adverse reactions in the observation group was 12.1%,which was significantly lower than that in the reference group,the difference was statistically significant(χ^(2)=5.280,P=0.021).Conclusion Applying standard trauma craniotomy with large bone flap to treat patients with severe head injury can improve the level of inflammatory factors and nerve function in patients,and it has positive significance for the improvement of the clinical treatment effect of patients.