大骨瓣开颅减压术联合颅内压监测治疗重型颅脑损伤的疗效观察

Observation on the curative effect of severe craniocerebral injury by craniotomy with large bone flap craniotomy combined with intracranial pressure monitoring

目的 观察重型颅脑损伤通过大骨瓣开颅减压术联合颅内压监测治疗的疗效。方法 选取2018年10月至2020年9月本院收治的80例重型颅脑损伤患者作为研究对象,采用交替分组法分为对照组和观察组,每组40例。对照组实施大骨瓣开颅减压术,观察组在对照组基础上联合颅内压监测治疗,比较两组颅内压水平、脱水剂使用量、ICU入住时间、并发症发生情况及远期疗效。结果 术后1、3、7 d,观察组术后颅内压水平均低于对照组(P<0.05);观察组脱水剂使用量少于对照组,ICU入住时间短于对照组(P<0.05);观察组并发症发生率为5.00%,低于对照组的20.00%(P<0.05);观察组恢复良好率为45.00%,高于对照组的20.00%(P<0.05)。结论 大骨瓣开颅减压术联合颅内压监测治疗重型颅脑损伤疗效确切,能明显改善患者颅内压水平,缩短恢复时间,降低并发症发生率。

Objective To observe the therapeutic effect of large bone flap craniotomy combined with intracranial pressure monitoring for severe head injury. Methods A total of 80 patients with severe craniocerebral injury who were admitted to our hospital from October 2018 to September2020 were selected as the research subjects, and they were divided into the control group and the observation group according to alternate grouping,with 40 cases in each group. The control group was treated with large bone flap craniotomy and the observation group was treated with intracranial pressure monitoring on the basis of the control group, the levels of intracranial pressure, the amount of dehydrating agent, the ICU stay time, the incidence of complications and the long-term efficacy were compared between the two groups. Results At 1, 3, and 7 days after operation, the intracranial pressure level of the observation group was lower than those of the control group(P<0.05);the amount of dehydrating agent used in the observation group was less than that of the control group, and the ICU stay time was shorter than that of the control group(P<0.05);the incidence of complications in the group was 5.00%, which was lower than 20.00% in the control group(P<0.05);the good recovery rate in the observation group was45.00%, which was higher than 20.00% in the control group(P<0.05). Conclusion Large bone flap craniotomy combined with intracranial pressure monitoring is effective in the treatment of severe craniocerebral injury, can significantly improve the level of intracranial pressure, shorten the recovery time, and reduce the incidence of complications.