标准大骨瓣开颅减压术治疗基底节区脑出血并发脑疝患者的临床效果

Clinical effect of standard large bone flap craniotomy and decompression in the treatment of patients with cerebral hemorrhage in basal ganglia area complicated with cerebral hernia

目的 探究标准大骨瓣开颅减压术治疗基底节区脑出血并发脑疝患者的临床效果。方法 纳入2019年3月至2021年3月本院收治的124例基底节区脑出血并发脑疝患者为研究对象,根据手术治疗方式不同将其分为对照组和观察组,每组62例。对照组开展常规骨瓣开颅术,观察组开展标准大骨瓣开颅减压术。比较两组患者的治疗效果。结果 观察组的手术时间、住院时间均显著短于对照组(P<0.05)。观察组的术后并发症总发生率低于对照组(P<0.05)。术后1周,观察组的美国国立卫生院卒中量表(NIHSS)评分、颅内压低于对照组,生活质量评分高于对照组(P<0.05)。术后1周,观察组的大脑中动脉搏动指数(PI)小于对照组,大脑中动脉平均血流速度(Vm)高于对照组(P<0.05)。结论 标准大骨瓣开颅减压术治疗基底节区脑出血并发脑疝的效果显著,可改善患者的神经功能、生活质量、颅内压及脑血流指标,且安全性良好。

Objective To explore the clinical effect of standard large bone flap craniotomy and decompression in the treatment of patients with cerebral hemorrhage in basal ganglia area complicated with cerebral hernia.Methods A total of 124 patients with cerebral hemorrhage in basal ganglia area complicated with cerebral hernia admitted in our hospital from March 2019 to March 2021 were included as research objects and divided into control group and observation group according to different surgical treatment methods,with 62 cases in each group.The control group received conventional craniotomy,and the observation group received standard large bone flap craniotomy and decompression.The therapeutic effects of the two groups were compared.Results The operation time and hospital stay in the observation group were significantly shorter than those in the control group(P<0.05).The total incidence of postoperative complications in the observation group was lower than that in the control group(P<0.05).One week after surgery,the National Institutes of Health Stroke Scale(NIHSS)score and intracranial pressure of the observation group were lower than those of the control group,while the quality of life score was higher than that of the control group(P<0.05).One week after surgery,pulsatility index(PI)of middle cerebral artery in the observation group was less than that in the control group,and mean velocity(Vm)of middle cerebral artery was higher than that in the control group(P<0.05).Conclusion The standard large bone flap craniotomy and decompression in the treatment of cerebral hemorrhage in basal ganglia area complicated with cerebral hernia has a significant effect,which can improve the neurological function,quality of life,intracranial pressure and cerebral blood flow indexes of patients,and the operation safety is good.