重型颅脑外伤采用大骨瓣开颅手术治疗的优越性分析以及对患者颅内感染的影响观察

Aadvantages Analysis of Large Bone Flap Craniotomy in Treatment of Severe Traumatic Brain Injury and Effect Observation on Intracranial Infection of Patients

目的 分析探讨重型颅脑外伤采用大骨瓣开颅手术治疗的优越性以及对患者颅内感染的影响。方法 随机抽取88例重型脑外伤患者,其均于2017年8月-2022年8月在本院就诊,依照随机动态原则进行分组,将其分为对照组44例,实验组44例,并分别给予常规骨瓣开颅手术、大骨瓣开颅手术,比较2组患者治疗的临床效果以及对患者颅内感染的影响。结果 相较于对照组,实验组镇静5min、镇静30min的心率和血压变化幅度明显更小,组间差异显著(P>0.05)。相较于对照组(68.18%),实验组的总有效率明显更高,达到了86.36%,组间差异显著(P<0.05);相较于对照组,实验组术后各个时间点的颅内压明显更低,组间差异显著(P<0.05);相较于对照组,实验组下床时间、住院时间、并发症发生率、生活质量评分等指标均明显更优,组间差异显著(P<0.05);相较于对照组(13.64%),实验组颅内感染率明显更低,只有2.27%,组间差异显著(P<0.05)。结论 大骨瓣开颅手术应用于重型颅脑外伤患者治疗中具有显著的优越性,不仅能够快速降低患者颅内压,还能够减少颅内感染风险,帮助患者尽快恢复健康。

Objective To analyze and explore advantages of large bone flap craniotomy in treatment of severe traumatic brain injury and its effect on intracranial infection of patients.Methods The paper chose 88 patients with severe brain injury treated in our hospital from August 2017 to August 2022,and divided them into control group 44 cases and experimental group 44 cases based on dynamic randomization principle,treated with routine bone flap craniotomy and large bone flap craniotomy respectively.Clinical effect of treatment and effect on intracranial infection between two groups was compared.Results Experimental group showed significantly smaller changes in heart rate and blood pressure after 5 minutes and 30 minutes of sedation than control group,with significant difference between the groups(P>0.05).Total effective rate of experimental group was 86.36%,significantly higher than control group(68.18%),with significant difference between groups(P<0.05).Intracranial pressure of experimental group at various time points after surgery was significantly lower than control group,with significant difference between groups(P<0.05).Experimental group showed significantly better indicators including out of bed time,length of hospital stay,incidence of complications and life quality scores than control group,with significant difference between groups(P<0.05).Intracranial infection rate in experimental group was only 2.27%,significantly lower than control group(13.64%),with significant difference between the groups(P<0.05).Conclusion Large bone flap craniotomy has significant advantages in treatment of severe traumatic brain injury patients,can reduce intracranial pressure quickly,reduce intracranial infection risk and recover health of patients as soon as possib le.