重型脑外伤应用改良外伤大骨瓣手术治疗的临床效果

A Clinical Study on the Application of Modified Large Bone Flap Surgery in the Treatment of Severe Traumatic Brain Injury

目的本研究旨在评估改良外伤大骨瓣手术在重型脑外伤患者治疗中的临床效果。方法本研究选取了30例重型脑外伤患者为研究对象,均为2020年3月至2022年2月期间在聊城市第三人民医院神经外科接受治疗,根据治疗方法不同分为对照组(15例)和观察组(15例)。所有患者在手术前接受统一的治疗措施,术后进行了抗生素治疗和营养支持,同时监测了血清炎症指标(hs-CRP、IL-6、TNF-α)、颅内压水平、GCS评分、NIHSS评分,以及GOS评分和术后并发症发生率。结果术后观察组患者的炎症指标水平、颅内压水平、NIHSS评分以及并发症发生率均低于对照组,GCS评分、GOS评分以及预后良好率均高于对照组(均P<0.05)。结论对重型脑外伤患者应用改良外伤大骨瓣手术能有效降低术后患者的炎症水平和颅内压,提高患者的意识状态,改善神经功能。

Objective The aim of this study was to evaluate the clinical effect of modified traumatic large bone flap surgery in the treatment of patients with severe traumatic brain injury.Methods In this study,30 patients with severe traumatic brain injury were selected as research subjects,all of whom were treated in the neurosurgery department of the Third People's Hospital of Liaocheng City between March 2020 and February 2022,and were divided into a control group and an observation group according to the different treatment methods,with 15 cases in each group.All patients received unified therapeutic measures before surgery,and antibiotic treatment and nutritional support were provided after surgery,while serum inflammatory indexes(hs-CRP,IL-6,and TNF-α),intracranial pressure,GCS score,and NIHSS score,as well as the incidence of postoperative complications and GOS score were monitored.Results In the postoperative period,the levels of inflammatory indexes,intracranial pressure,NIHSS score,and complication rate of patients in the observation group were lower than those in the control group,and the GCS score,GOS score and good prognosis rate were higher than those in the control group(all P<0.05).Conclusions Modified traumatic large bone flap surgery can effectively reduce the postoperative inflammation level and intracranial pressure in patients with severe traumatic brain injury,improve the patient's state of consciousness,and improve neurological function.