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标准大骨瓣开颅术治疗重型额颞部颅脑损伤患者的临床疗效及预后

Clinical efficacy and prognosis of standard large trauma craniotomy for patients with severe frontotemporal craniocerebral injury.

作者信息

Huang Zhiqi, Yan Lijin

机构信息

Department of Intensive Care Unit, Hubei Hanchuan People's Hospital Hanchuan 431600, Hubei Province, China.

Department of Medical Examination Services, Hubei Hanchuan People's Hospital Hanchuan 431600, Hubei Province, China.

出版信息

Am J Transl Res. 2022 Jan 15;14(1):476-483. eCollection 2022.

Abstract

OBJECTIVE

To observe the clinical efficacy, incidence of postoperative complications, and the quality of life in patients with severe craniocerebral injury undergoing standard large trauma craniotomy.

METHODS

Seventy-eight patients with severe craniocerebral injury who had been admitted to Hubei Hanchuan People's Hospital were selected retrospectively and assigned into an observation group and control group according to the treatment received, with 39 patients in each group. Patients in the control group were treated with conventional decompressive craniotomy and those in the observation group with standard large trauma craniotomy. The prognosis (GOS score), intracranial pressure before and after surgery, neurological functions (NIHSS score), cerebral hemodynamics (Vm, Vs, PI), quality of life (SF-36 score) and postoperative complications were compared.

RESULTS

The number of patients whose GOS scores were graded 5 was markedly higher in the observation group than that in the control group (P<0.05). The postoperative intracranial pressure and NIHSS scores in the observation group were lower than those in the control group (P<0.001). The postoperative Vm, Vs and PI were lower in the observation group than those in the control group, respectively (P<0.001). There was no statistical difference in the incidence of complications in the two groups (P>0.05). The SF-36 scores in the observation group were higher than those of the control group (P<0.01).

CONCLUSION

Standard large trauma craniotomy is effective in treating patients with severe frontotemporal craniocerebral injury. It decreases intracranial pressure, improves neurological function and quality of life and results in a good prognosis.

摘要

目的

观察标准大骨瓣开颅术治疗重型颅脑损伤患者的临床疗效、术后并发症发生率及生活质量。

方法

回顾性选取湖北省汉川市人民医院收治的78例重型颅脑损伤患者,根据治疗方法分为观察组和对照组,每组39例。对照组采用传统减压开颅术治疗,观察组采用标准大骨瓣开颅术治疗。比较两组患者的预后(GOS评分)、手术前后颅内压、神经功能(NIHSS评分)、脑血流动力学(Vm、Vs、PI)、生活质量(SF-36评分)及术后并发症。

结果

观察组GOS评分5级患者数量明显多于对照组(P<0.05)。观察组术后颅内压及NIHSS评分低于对照组(P<0.001)。观察组术后Vm、Vs及PI分别低于对照组(P<0.001)。两组并发症发生率比较,差异无统计学意义(P>0.05)。观察组SF-36评分高于对照组(P<0.01)。

结论

标准大骨瓣开颅术治疗重型额颞部颅脑损伤患者疗效显著,可降低颅内压,改善神经功能及生活质量,预后良好。

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