临床外科杂志 ›› 2022, Vol. 30 ›› Issue (12): 1120-1122.doi: 10.3969/j.issn.1005-6483.2022.12.007

• 论著 • 上一篇    下一篇

颅内压监测阶梯减压联合不同时机颅骨缺损修复对重型颅脑损伤病人的疗效及对其血清指标及预后的影响分析

  

  1. 226600 江苏省海安市人民医院创伤外科(袁宝玉、陆正、王东流),神经外科(管义祥、蔡舒、刘中平)
  • 收稿日期:2022-05-10 接受日期:2022-05-10 出版日期:2022-12-20 发布日期:2023-01-20
  • 通讯作者: 管义祥,Email:haianswgyx@163.com
  • 基金资助:
    江苏省卫生健康委科研项目(Z2019033)

Analysis of the efficacy of stepwise decompression with intracranial pressure monitoring combined with different timing of skull defect repair in patients with sTBI and the effect on their serum indicators and prognosis

  1. Department of Trauma Surgery,Hai'an People's Hospital,Jiangsu,Nantong 226600,China
  • Received:2022-05-10 Accepted:2022-05-10 Online:2022-12-20 Published:2023-01-20

摘要: [摘要] 目的 探讨颅内压监测阶梯减压联合不同时机颅骨缺损修复对重型颅脑损伤(STBI)病人的疗效及对其血清指标及预后的影响。方法 STBI病人73例,根据治疗方式将其分为两组,其中研究组40例,采用颅内压监测阶梯减压联合超早期颅骨缺损修复治疗,对照组33例,采用颅内压监测阶梯减压联合常规时间颅骨缺损修复治疗,比较两组病人的临床疗效,血清降钙素原及C反应蛋白的影响。结果 研究组的恢复良好率高于对照组(P<0.05);研究组炎性相关检验指标均比对照组改善(P<0.05);研究组并发症发生率低于对照组,大脑中动脉(MCA)平均血流速度比对照组明显改善(P<0.05);研究组的预后优于对照组(P<0.05)。结论颅内压监测阶梯减压联合超早期颅骨缺损修复治疗重型颅脑损伤疗效显著,可减轻炎性状态并改善其脑血流灌注情况,并发症发生率降低。

关键词: 颅内压监测阶梯减压, 超早期颅骨缺损修复;重型颅脑损伤, 疗效, 血清, 预后

Abstract: [Abstract] Objective To investigate the efficacy of stepwise decompression with intracranial pressure monitoring combined with different timing of skull defect repair in patients with sTBI and the effect on their serum indicators and prognosis. Methods Seventy-three patients with STBI who were admitted to our hospital were selected for the study.They were divided into 2 groups according to the differences in treatment modalities.Among them,40 patients in the study group were treated with intracranial pressure monitoring step decompression combined with ultra-early skull defect repair,while 33 patients in the control group were treated with intracranial pressure monitoring step decompression combined with conventional time skull defect repair,comparing the clinical efficacy and other differences between the two groups. Results After treatment,the rate of good recovery was significantly higher in the study group than in the control patients(P<0.05);All inflammation-related test indexes in the study group improved significantly after treatment compared with the control group(P<0.05);After treatment,the incidence of complications was significantly lower in the study group than in the control group(P<0.05).The mean MCA flow velocity in the study group improved significantly after treatment compared with the control group(P<0.05).After treatment,the prognosis of the study group was significantly better than that of the control patients(P<0.05). Conclusion The efficacy of intracranial pressure monitoring step decompression combined with ultra-early skull defect repair in the treatment of patients with heavy craniocerebral injury is remarkable,and it can reduce the inflammatory state of patients and improve their cerebral perfusion,and reduce the incidence of complications.

Key words: intracranial pressure monitoring step decompression, ultra-early skull defect repair, heavy craniocerebral injury, efficacy, serum, prognosis

[1] 薛志有 倪志海 张毅. 胃癌组织中维甲酸相关孤儿受体α、微管相关蛋白轻链3的表达与病人远期预后的关系[J]. 临床外科杂志, 2022, 30(9): 839-843.
[2] 季金涛 康波 苏燕胜. 前列腺特异性膜抗原与前列腺癌Gleason评分的相关性分析及在早期诊断及预后中的价值[J]. 临床外科杂志, 2022, 30(9): 885-888.
[3] 原野 刘涛 刘华. 食管鳞癌组织微小RNA-138、微小RNA-145表达水平与1型/2型辅助性T细胞漂移和预后的关系[J]. 临床外科杂志, 2022, 30(8): 744-748.
[4] 罗耀兵 杨武军 王兴平 李美清. 颅内压监测下阶梯减压术对急诊颅脑创伤病人炎症反应、代谢状态及预后的影响[J]. 临床外科杂志, 2022, 30(7): 640-643.
[5] 张春啸 孙艳凤 严斌 张长青 刘东英 宋矿鹏 邱国良. 内侧固定平台与活动平台单髁置换对自发性膝关节骨坏死的疗效比较[J]. 临床外科杂志, 2022, 30(7): 670-672.
[6] 刘国路 李强 李乾 王苏贵. 循环miR-485-5p水平与前列腺癌病人病理参数的关系及其对预后的价值[J]. 临床外科杂志, 2022, 30(7): 673-676.
[7] 袁赵 郑昂. 腹腔镜下脾切除术联合经内镜下套扎序贯硬化剂治疗对门静脉高压症病人的疗效及对其血流动力学及预后的影响[J]. 临床外科杂志, 2022, 30(7): 691-693.
[8] 薛诚 马骏. 未破裂颅内动脉瘤病人血清miR-448-3p、KLF5表达水平及临床意义[J]. 临床外科杂志, 2022, 30(6): 565-568.
[9] 张志鸿 李炎阳 李珂佳 邵国辉 翟广 党学渊 陈晓星 苏纪烽 罗炯 李金泽 戈佳云. 开腹和腹腔镜肝切除术治疗复杂肝胆管结石的疗效评价和策略分析[J]. 临床外科杂志, 2022, 30(6): 572-575.
[10] 李宗富 陈铁良 丁梅 王增辉 陈建利. 快速康复外科对早期胃癌腹腔镜辅助保留幽门胃切除术患者营养状态的影响分析[J]. 临床外科杂志, 2022, 30(5): 433-436.
[11] 阮添 李昌盛 杨泽天 周雪峰 王乐. 内脏胸膜侵犯对术后ⅢA/N2期非小细胞肺癌病人生存的影响:SEER数据库分析[J]. 临床外科杂志, 2022, 30(5): 448-452.
[12] 叶彬 向秋 金文杰. 叉头框蛋白Q1和细胞周期蛋白D1在非小细胞肺癌组织中的表达与临床病理特征及预后的关系[J]. 临床外科杂志, 2022, 30(5): 453-458.
[13] 詹浩东 王荣 李剑. 改良格拉斯哥预后评分联合纤维蛋白原与前白蛋白比值对胸腔镜肺叶切除术治疗肺癌的预后评估价值[J]. 临床外科杂志, 2022, 30(5): 459-462.
[14] 卞春安 田晓奇 林超宇 许里. CRYAB在肺鳞癌中的表达及其临床意义[J]. 临床外科杂志, 2022, 30(5): 486-489.
[15] 杨恒 张军 郭强 林称意 罗卫民 原野 程栋梁 罗湘玉 刘华 郭家龙. 基于多数据库分析HLA-DPB1在肺腺癌中的潜在价值[J]. 临床外科杂志, 2022, 30(4): 339-344.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] 杨华;李新长;龙成美;等. 公民逝世后器官捐献供肾移植临床分析[J]. 临床外科杂志, 2016, 24(10): 747 .
[2] 宋华;单若冰;张晋绥;等. 产前超声诊断对新生儿消化道梗阻性疾病手术治疗价值的观察[J]. 临床外科杂志, 2016, 24(10): 780 .
[3] 涂儒鸿;黄昌明. 腹腔镜胃癌根治术淋巴结清扫技巧[J]. 临床外科杂志, 2016, 24(11): 809 .
[4] 范强金;郑鹏超;李振军. 原发性肺软骨肉瘤病一例[J]. 临床外科杂志, 2016, 24(4): 320 .
[5] 叶章群;刘浩然. 泌尿系结石的诊断治疗进展[J]. 临床外科杂志, 2017, 25(2): 85 .
[6] 戴静;钱群. 2017.V1版《NCCN直肠癌诊治指南》更新解读[J]. 临床外科杂志, 2017, 25(4): 245 .
[7] 许平平;许剑民. 机器人在结直肠癌手术中的应用现状[J]. 临床外科杂志, 2017, 25(4): 255 .
[8] 刘建华. 骨细胞同种异体移植物用于踝关节融合术后疗效评估[J]. 临床外科杂志, 2017, 25(4): 292 .
[9] 喻少敏;郭卫春. 二十二碳六烯酸在急性脊髓损伤后早期炎性反应中的作用[J]. 临床外科杂志, 2017, 25(4): 301 .
[10] 孟旭;张海波;韩薇. 再议中国风湿性二尖瓣修复技术的临床应用[J]. 临床外科杂志, 2017, 25(5): 335 .