标准大骨瓣减压术治疗重型脑外伤的临床效果研究

Clinical Effects of Standard Large Bone Flap Decompression in the Treatment of Severe Traumatic Brain Injury

目的探讨标准大骨瓣减压术治疗重型脑外伤的临床效果。方法选取2020年3月—2023年3月南京市六合区人民医院收治的80例重型脑外伤患者的临床资料进行回顾性分析,按照患者不同手术治疗方案分组,其中以常规颞顶瓣开颅减压术治疗的40例作为对照组,以标准大骨瓣减压术治疗的40例作为观察组。比较两组治疗疗效、并发症发生率、功能评分、颅内压水平。结果术后1、3、7 d,观察组颅内压水平分别为(23.93±4.11)、(18.92±3.41)、(14.20±2.95)mmHg,低于对照组的(28.36±4.28)、(23.72±3.58)、(18.77±3.22)mmHg,差异有统计学意义(t=4.722、6.140、6.619,P<0.05)。观察组脑膨出等并发症发生率为15.00%,低于对照组的32.50%,差异有统计学意义(χ^(2)=8.571,P<0.05)。观察组格拉斯哥昏迷、格拉斯哥预后评分为(11.59±1.88)分、(4.03±0.49)分,高于对照组的(9.92±1.92)分、(3.12±0.61)分,差异有统计学意义(P<0.05)。结论标准大骨瓣减压术治疗重型脑外伤可更好地降低颅内压,减少并发症,促进患者恢复。

Objective To explore the clinical effect of standard large bone flap decompression for severe traumatic brain injury.Methods The clinical data of 80 patients with severe traumatic brain injury treated in Nanjing Lihe District People's Hospital from March 2020 to March 2023 were retrospectively analyzed.The patients were grouped according to different surgical treatment plans.40 patients treated with conventional temporoparietal craniotomy decompression were selected as the control group,and 40 patients treated with standard large craniotomy decompression were selected as the observation group.The therapeutic effect,the incidence of complications,functional scores and intracranial pressure were compared between the two groups.Results 1,3 and 7 days after operation,the intracranial pressure levels in the observation group were(23.93±4.11)mmHg,(18.92±3.41)mmHg and(14.20±2.95)mmHg,which were lower than those in the control group(28.36±4.28)mmHg,(23.72±3.58)mmHg and(18.77±3.22)mmHg,respectively,the difference was statistically significant(t=4.722,6.140,6.619,P<0.05).The incidence of complications such as encephalocele in the observation group was 15.00%,lower than that in the control group(32.50%),and the difference was statistically significant(χ^(2)=8.571,P<0.05).The Glasgow Coma Scale and Glasgow Outcome Scale scores of the observation group were(11.59±1.88)points and(4.03±0.49)points,which were higher than those of the control group(9.92±1.92)points,(3.12±0.61)points,the difference was statistically significant(P<0.05).Conclusion Standard large craniotomy for severe traumatic brain injury can better reduce intracranial pressure,reduce complications and promote patient recovery.