控制性阶梯式减压术对重型颅脑损伤患者炎症因子及神经功能的影响

Effect of controlled stepwise decompression on inflammatory factors and neurological function in patients with severe head injury

目的探讨重型颅脑损伤(SCI)选用控制性阶梯式减压术的效果,以及对炎症因子、神经功能影响。方法选取2019年10月至2022年10月湘乡市人民医院神经外科的80例SCI患者作为研究对象,采用奇偶数分组法将其分为对照组和观察组,各40例。对照组采用标准大骨瓣减压术,观察组采用控制性阶梯式减压术。比较两组的炎症因子、神经功能、颅内压、脑代谢指标。结果观察组治疗后的炎症因子、神经功能、颅内压、颈内动脉血氧含量(CaO_(2))低于对照组,差异有统计学意义(P<0.05);颈内静脉血氧饱和度(SjvO_(2))、脑氧摄取率(CERO_(2))、颈内静脉血氧含量(CjvO_(2))指标高于对照组,差异有统计学意义(P<0.05)。结论对SCI患者行控制性阶梯式减压术,能降低炎症因子,恢复神经功能,有效降低颅内高压,改变脑代谢指标,进而增强机体免疫力、抵抗力,值得推广。

Objective To investigate the effectiveness of using controlled stepwise decompression surgery for severe head injury(SCI)and its impact on inflammatory factors with neurological function.Methods A total of 80 SCI patients in Department of Neurosurgery of People's Hospital of Xiangxiang from October 2019 to October 2022 were selected as the research objects,and they were divided into control group and observation group by odd even number grouping method,with 40 cases in each group.Standard large bone flap decompression surgery was selected for the control group,while controlled stepwise decompression surgery was selected for the observation group.Inflammatory factors,neurological function,intracranial pressure and brain metabolic indexes were compared between the two groups.Results There were no significant differences in inflammatory factors,neurological function,Intracranial pressure and brain metabolism between the two groups before treatment(P>0.05).Inflammatory factors,neurological function,Intracranial pressure and blood oxygen content of internal carotid artery(CaO_(2))in the observation group after treatment were lower than those in the control group,with statistically significant differences(P<0.05).The indicators of internal jugular vein oxygen saturation(SjvO_(2)),cerebral oxygen uptake rate(CERO_(2)),and internal jugular vein oxygen content(CjvO_(2))were higher than those of the control group,with statistically significant differences(P<0.05).Conclusion Controlled stepwise decompression surgery for SCI patients can reduce inflammatory factors,restore neurological function,effectively reduce intracranial hypertension,change brain metabolic indicators,and enhance immunity and resistance,which is worth promoting.