中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2015年
4期
240-242
,共3页
陈伟%彭思民%揭芳剑%黄俏春
陳偉%彭思民%揭芳劍%黃俏春
진위%팽사민%게방검%황초춘
减压%颅脑损伤%脑膜膨出%血肿
減壓%顱腦損傷%腦膜膨齣%血腫
감압%로뇌손상%뇌막팽출%혈종
Decompression%Craniocerebral trauma%Meningocele%Hematoma
目的 探讨梯度减压防治重型颅脑损伤手术中急性脑膨出的临床疗效.方法 回顾性分析重型颅脑损伤开颅手术患者178例,梯度减压组(103例)采用梯度减压术进行治疗,常规减压组(75例)采用常规减压术进行治疗,对比分析两组疗效.结果 梯度减压组患者术中急性脑膨出28例(27.18％,28/103)、迟发性颅内血肿13例(12.62％,13/103),常规减压组急性脑膨出41例(54.67％,41/75)、迟发性颅内血肿20例(26.67％,20/75),两组比较差异有统计学意义(P＜ 0.01或＜0.05);出院后3个月,梯度减压组失访21例,常规减压组失访15例,梯度减压组恢复良好率[29.27％(24/82)]及病死率[36.59％ (30/82)]明显优于常规减压组[15.00％ (9/60)、55.00％(33/60)],差异有统计学意义(P＜0.05).结论 梯度减压通过稳步释放颅内压力,可以有效减少重型颅脑损伤患者手术中急性脑膨出的发生,对提高重型颅脑损伤的救治及预后具有积极意义.
目的 探討梯度減壓防治重型顱腦損傷手術中急性腦膨齣的臨床療效.方法 迴顧性分析重型顱腦損傷開顱手術患者178例,梯度減壓組(103例)採用梯度減壓術進行治療,常規減壓組(75例)採用常規減壓術進行治療,對比分析兩組療效.結果 梯度減壓組患者術中急性腦膨齣28例(27.18％,28/103)、遲髮性顱內血腫13例(12.62％,13/103),常規減壓組急性腦膨齣41例(54.67％,41/75)、遲髮性顱內血腫20例(26.67％,20/75),兩組比較差異有統計學意義(P＜ 0.01或＜0.05);齣院後3箇月,梯度減壓組失訪21例,常規減壓組失訪15例,梯度減壓組恢複良好率[29.27％(24/82)]及病死率[36.59％ (30/82)]明顯優于常規減壓組[15.00％ (9/60)、55.00％(33/60)],差異有統計學意義(P＜0.05).結論 梯度減壓通過穩步釋放顱內壓力,可以有效減少重型顱腦損傷患者手術中急性腦膨齣的髮生,對提高重型顱腦損傷的救治及預後具有積極意義.
목적 탐토제도감압방치중형로뇌손상수술중급성뇌팽출적림상료효.방법 회고성분석중형로뇌손상개로수술환자178례,제도감압조(103례)채용제도감압술진행치료,상규감압조(75례)채용상규감압술진행치료,대비분석량조료효.결과 제도감압조환자술중급성뇌팽출28례(27.18％,28/103)、지발성로내혈종13례(12.62％,13/103),상규감압조급성뇌팽출41례(54.67％,41/75)、지발성로내혈종20례(26.67％,20/75),량조비교차이유통계학의의(P＜ 0.01혹＜0.05);출원후3개월,제도감압조실방21례,상규감압조실방15례,제도감압조회복량호솔[29.27％(24/82)]급병사솔[36.59％ (30/82)]명현우우상규감압조[15.00％ (9/60)、55.00％(33/60)],차이유통계학의의(P＜0.05).결론 제도감압통과은보석방로내압력,가이유효감소중형로뇌손상환자수술중급성뇌팽출적발생,대제고중형로뇌손상적구치급예후구유적겁의의.
Objective To investigate the clinical curative effect of ladder-type decompression in preventing acute encephalocele in the operation of severe craniocerebral trauma.Methods The clinical data of 178 patients after operation of severe craniocerebral trauma were retrospectively analyzed.The patients were divided into routine decompression group (75 cases) and ladder-type decompression group (103 cases).The former was treated by routine decompression,and the latter was treated by ladder-type decompression.The efficacy was compared and analyzed.Results The incidence of acute encephalocele and delayed hematoma in ladder-type decompression group were 27.18％ (28/103) and 12.62％ (13/103),in routine decompression group were 54.67％ (41/75) and 26.67％ (20/75),and the differences between two groups were statistically significant (P ＜ 0.01 or ＜ 0.05).Three months after discharge,21 cases were lost in ladder-type decompression group and 15 cases were lost in routine decompression group.Recovery rate and death rate in ladder-type decompression group were 29.27％ (24/82) and 36.59％ (30/82),in routine decompression group were 15.00％ (9/60) and 55.00％ (33/60),and the differences were statistically significant (P＜ 0.05).Conclusion Ladder-type decompression can effectively reduce the incidence of acute encephaloceie via the steady release of intracranial pressure,which has positive significance in the improvement of the treatment and prognosis of severe craniocerebral injury.
