单纯内减压术治疗儿童重型颅脑损伤的临床效果分析

Clinical Effect Analysis of Internal Decompression Alone in the Treatment of Severe Craniocerebral Injury in Children

目的:分析单纯内减压术治疗儿童重型颅脑损伤的临床效果。方法:选取2021年5月—2023年6月西安医学院附属宝鸡医院收治的重型颅脑损伤患儿132例作为研究对象,采用随机数字表法分为常规组与观察组,各66例。常规组接受传统开颅手术治疗,观察组接受单纯内减压术治疗。比较两组患儿神经功能、临床指标、治疗效果及术后不良反应发生情况。结果:术前,两组美国国立卫生研究院卒中量表(NIHSS)评分比较,差异无统计学意义(P>0.05);术后,两组NIHSS评分都降低,观察组低于常规组,差异有统计学意义(P<0.05)。术前,两组平均动脉压、颅内压、脑灌注压比较,差异无统计学意义(P>0.05);术后,两组平均动脉压、颅内压、脑灌注压降低,观察组低于常规组,差异有统计学意义(P<0.05)。观察组治疗总有效率高于常规组,差异有统计学意义(P<0.001)。观察组术后不良反应总发生率低于常规组,差异有统计学意义(P<0.001)。结论:单纯内减压术治疗儿童重型颅脑损伤的临床效果显著,可改善患儿神经功能,降低颅内压,降低术后不良反应发生风险。

Objective:To analyze the clinical effect of internal decompression alone in the treatment of severe craniocerebral injury in children.Methods:A total of 132 children with severe craniocerebral injury were selected as the study objects at Xi'an Medical College Affiliated Baoji Hospital from May 2021 to June 2023,and were divided into routine group and observation group by random number table method,with 66 cases in each group.The routine group received routine craniotomy,and the observation group received internal decompression alone.Neurological function,clinical indexes,therapeutic effect and postoperative adverse reactions were compared between the two groups.Results:Before surgery,there was no significant difference in the score of National Institutes of Health Stroke Scale(NIHSS)between the two groups(P>0.05).After operation,the NIHSS score of the two groups was decreased,and the observation group was lower than the routine group,with statistical significance(P<0.05).Before operation,there was no significant difference in mean arterial pressure,intracranial pressure and cerebral perfusion pressure between the two groups(P>0.05).After operation,the mean arterial pressure,intracranial pressure and cerebral perfusion pressure of the two groups were decreased,and the observation group was lower than the routine group,the difference was statistically significant(P<0.05).The total effective rate of the observation group was higher than that of the routine group,the difference was statistically significant(P<0.001).The total incidence of postoperative adverse reactions in the observation group was lower than that in the routine group,and the difference was statistically significant(P<0.001).Conclusion:Internal decompression alone has significant clinical effects in the treatment of severe craniocerebral injury in children,which can improve neurological function,reduce cranial pressure and reduce the risk of postoperative adverse reactions.