用颅内压监测下阶梯式颅内减压术治疗急性重型颅脑损伤的价值研究

Value of stepwise intracranial decompression under intracranial pressure monitoring in the treatment of acute severe craniocerebral injury

目的:研究为急性重型颅脑损伤患者应用颅内压监测下阶梯式颅内减压术进行治疗的临床效果。方法:择取2019年6月至2021年6月肇庆市第一人民医院接诊的40例急性重型颅脑损伤患者,将其按随机数表法分为大骨瓣减压组和阶梯式减压组,每组20例患者。为大骨瓣减压组患者采用传统的大骨瓣减压术进行治疗,为阶梯式减压组患者采用颅内压监测下阶梯式颅内减压术进行治疗,然后对比两组患者格拉斯哥昏迷评分法(GCS)的评分和术后并发症的发生情况。结果:1)治疗前,两组患者的GCS评分相比,差异无统计学意义(P>0.05)。治疗后,两组患者的GCS评分均显著提高,且阶梯式减压组患者的GCS评分高于大骨瓣减压组患者,差异有统计学意义(P<0.05)。2)阶梯式减压组患者术后并发症的发生率低于大骨瓣减压组患者,差异有统计学意义(P<0.05)。结论:与采用传统的大骨瓣减压术相比,用颅内压监测下阶梯式颅内减压术治疗急性重型颅脑损伤的临床效果较好,可有效提高患者的GCS评分,降低其术后并发症的发生率,改善其预后。

Objective:To study the clinical effect of stepped intracranial decompression under intracranial pressure monitoring in the treatment of patients with acute severe craniocerebral injury.Methods:A total of 40 patients with acute severe craniocerebral injury admitted to Zhaoqing First People’s Hospital from June 2019 to June 2021 were selected and divided into large craniocerebral decompression group and stepped decompression group according to the random number table method,with 20 patients in each group.Patients in the large bone flap decompression group were treated with traditional large bone flap decompression,and patients in the step decompression group were treated with step intracranial decompression under intracranial pressure monitoring.Then the Glasgow coma scale(GCS)score and postoperative complications were compared between the two groups.Results:1)Before treatment,there was no significant difference in GCS score between the two groups(P>0.05).After treatment,the GCS score of patients in both groups was significantly improved,and the GCS score of patients in the step decompression group was higher than that of patients in the large bone flap decompression group,and the difference was statistically significant(P<0.05).2)The incidence of postoperative complications in the step decompression group was lower than that in the large bone flap decompression group,and the difference was statistically significant(P<0.05).Conclusion:Compared with the traditional decompression of large bone flap,the clinical effect of intracranial decompression under intracranial pressure monitoring is better in the treatment of acute severe craniocerebral injury,which can effectively improve the GCS score of patients,reduce the incid ence of postoperative complications,and improve the prognosis.