阶梯减压术治疗重型颅脑损伤的临床价值分析.pdfVIP

JOURNALOFCHINESEANDFOREIGNMEDICINEANDPHARMACYRESEARCH论著·临床医学

阶梯减压术治疗重型颅脑损伤的临床价值分析

张贵城

733000武威市人民医院神经外科，甘肃武威

摘要目的：研究阶梯减压术（SD）治疗重型颅脑损伤（sTBI）的临床价值。方法：选择武威市人民医院2021年1月—

2024年1月收治的sTBI患者76例为研究对象，采取随机数字表法分成对照组、观察组，各38例。对照组接受去大骨瓣减

压术治疗，观察组接受SD治疗。比较两组炎性因子、脑代谢指标、并发症发生率、救治总有效率。结果：术后7d，观

察组白细胞介素-10、C反应蛋白、白细胞计数水平低于对照组（P＜0.001），混合静脉血氧饱和度、脑氧摄取率水平高

于对照组（P＜0.001）；观察组并发症发生率低于对照组（P=0.042）；观察组总有效率高于对照组（P=0.018）。结论：SD治疗

sTBI的效果显著，可有效改善患者炎性因子、脑代谢指标，安全性较高。

关键词阶梯减压术；重型；颅脑损伤；炎性因子；脑代谢

中图分类号R651.15文献标识码A

AnalysisofClinicalValueofStepwiseDecompressioninTreatmentofSevereTraumaticBrainInjury

ZhangGuicheng

NeurosurgeryDepartment,PeoplesHospitalofWuwei,Wuwei733000,GansuProvince,China

AbstractObjective:Toinvestigatetheclinicalvalueofstepwisedecompression(SD)surgeryintreatmentofseveretraumatic

braininjury(sTBI).Methods:Atotalof76patientswithsTBIwhoreceivedtreatmentatthePeoplesHospitalofWuweifromJanuary

2021toJanuary2024wereselectedasthestudysubjects.Theyweredividedintocontrolgroupandobservationgroupaccordingto

randomnumbertablemethod,with38casesineachgroup.Thecontrolgroupreceiveddecompressivehemicraniectomytreatment,

whiletheobservationgroupreceivedSDtreatment.Theinflammatoryfactors,brainmetabolicindicators,incidenceofcomplications,

andoverallresponseratewerecomparedbetweentwogroups.Results:On7daftersurgery,thelevelsofinterleukin-10,C-reactive

proteinandwhitebloodcellcountintheobservationgroupwerelowerthanthoseinthecontrolgroup(P0.001),andthelevelsof

mixedvenousoxygensaturationandcerebraloxygenextractionfractionintheobservationgroupwerehigherthanthoseinthe

controlgroup(P0.001).Theincidenceofcomplicationsintheobservationgroupwaslowerthanthatinthecontrolgroup

(P=0.042).Theoverallresponserateintheobservationgroupwashigherthanthatinthecontrolgroup(P=0.018).Conclusion:SD

hasasignificanteffectinthetreatmentofsTBI,andcaneffectivelyim