| 曹培超,杨瑞霞,张海军,薛长理.颅内压监测下阶梯式减压在重型颅脑损伤患者术中的应用[J].中国烧伤创疡杂志,2021,(2):124~126. |
| DOI： |
| 中文关键词: 阶梯式减压 重型颅脑损伤 颅内压 意识 并发症 |
| 英文关键词:Stepwise decompression Severe craniocerebral injury Intracranial pressure Consciousness Complication |
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| 中文摘要: |
| 目的 探讨颅内压监测下阶梯式减压在重型颅脑损伤患者术中的应用效果。方法 选取2019年3月至2020年6月开封市中心医院收治的58例重型颅脑损伤患者作为研究对象，根据治疗方法将其分为观察组（29例）与对照组（29例）。观察组患者行颅内压监测下阶梯式减压术治疗，对照组患者行传统大骨瓣减压术治疗，对比两组患者格拉斯哥昏迷指数（GCS）评分变化情况、术后并发症（急性脑膨出、迟发脑血肿、术后脑梗死等）发生情况及死亡率。结果 术后1个月，观察组患者GCS评分为（10.67±2.19）分，明显高于对照组患者的（8.66±1.88）分（t=3.750，P＜0.001）；观察组患者术后出现急性脑膨出2例、术后脑梗死1例，并发症发生率为10.34%，对照组患者术后出现急性脑膨出5例、迟发脑血肿1例、术后脑梗死3例，并发症发生率为31.03%，两组间差异无统计学意义（χ2=3.783，P=0.052）；观察组患者中死亡6例，死亡率为20.69%，对照组患者中死亡12例，死亡率为41.38%，两组间差异无统计学意义（χ2=2.900，P=0.089）。结论 颅内压监测下阶梯式减压相对于传统大骨瓣减压而言，可明显促进患者意识恢复，提高患者预后。 |
| 英文摘要: |
| 【Abstract】Objective To investigate the application effect of ICP monitored stepwise intracranial decompression in patients with severe craniocerebral injury. Methods Fifty-eight patients with severe craniocerebral injuries，admitted to Kaifeng Central Hospital from March 2019 to June 2020 were selected as the research subjects to be divided into an observation group (29 cases) and a control group (29 cases) according to different treatments they received. Patients in the observation group underwent ICP monitored stepwise intracranial decompression while patients in the control group were treated with the conventional large decompressive craniectomy. The changes in Glasgow Coma Scale (GCS) score，postoperative complications (acute encephalocele，delayed cerebral hematoma，postoperative cerebral infarction，etc.) and mortality rate were compared between the two groups. Results One month after operation，the GCS score in the observation group was (10.67±2.19) points，which was significantly higher than (8.66±1.88) points in the control group (t=3.750，P＜0.001). In the observation group，2 patients suffered from acute encephalocele，1 patient had postoperative cerebral infarction and the complication rate was 10.34%，while 5 patients developed acute encephalocele，1 patient had delayed cerebral hematoma，3 patients had postoperative cerebral infarction and the complication rate was 31.03% in the control group，and the difference between the two groups was not statistically significant (χ2=3.783，P=0.052). In the observation group 6 patients died and the mortality rate was 20.69%，which showed no statistically significant difference as compared with 12 patients died and the mortality rate being 41.38 % in the control group (χ2=2.900，P=0.089). Conclusion Compared with the conventional large decompressive craniectomy，ICP monitored stepwise intracranial decompression can significantly promote the recovery of patients’ consciousness and improve their prognosis. |
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