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探讨大骨瓣开颅术对重型颅脑创伤患者脑血流动力学、颅内感染率及神经功能的影响。

Investigation of the Effects of Large Bone Flap Craniotomy on Cerebral Hemodynamics, Intracranial Infection Rate, and Nerve Function in Patients with Severe Craniocerebral Trauma.

机构信息

Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China.

出版信息

Contrast Media Mol Imaging. 2022 Sep 2;2022:2681278. doi: 10.1155/2022/2681278. eCollection 2022.

Abstract

In order to explore the clinical value of large bone flap craniotomy, the effects of standard large bone flap craniotomy on cerebral hemodynamic indexes, incidence of postoperative intracranial infection, and neurological function in patients with severe craniocerebral trauma are investigated. 89 patients with severe craniocerebral trauma admitted from January 2020 to June 2021 are analyzed retrospectively. All patients are divided into a large craniotomy group ( = 45) and control group ( = 44) according to different surgical methods. The large craniotomy group is treated with large craniotomy decompression, and the control group is treated with traditional craniotomy decompression. The incidence of intracranial infection in each group is recorded, and NIHSS is applied to observe the neurological function recovery of 2 groups before and 1 month after operation. Besides, the patients are followed up after surgery and the Kaplan-Meier survival curve is obtained to compare the survival rate of patients in the two groups. It is clearly evident that the two surgical methods have certain clinical efficacy in the treatment of patients with severe craniocerebral trauma. Comparatively, the large craniotomy can further improve brain blood supply and improve neurological function recovery. Also, it can obtain low incidence of postoperative adverse reactions and intracranial infection.

摘要

为了探讨大骨瓣开颅术的临床价值,研究标准大骨瓣开颅术对重型颅脑创伤患者脑血流动力学指标、术后颅内感染发生率和神经功能的影响。回顾性分析 2020 年 1 月至 2021 年 6 月收治的 89 例重型颅脑创伤患者。所有患者根据不同的手术方法分为大骨瓣开颅组( = 45)和对照组( = 44)。大骨瓣开颅组采用大骨瓣减压治疗,对照组采用传统开颅减压治疗。记录两组患者颅内感染的发生率,采用 NIHSS 观察两组患者术前及术后 1 个月的神经功能恢复情况。此外,对患者进行术后随访,并绘制 Kaplan-Meier 生存曲线比较两组患者的生存率。结果表明,两种手术方法在治疗重型颅脑创伤患者方面均具有一定的临床疗效。相比之下,大骨瓣开颅术能进一步改善脑血供,促进神经功能恢复,且术后不良反应和颅内感染发生率较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e507/9462990/3a826e5c9833/CMMI2022-2681278.001.jpg

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