CAJ | 학술논문

目的:探讨标准大骨瓣减压对重型颅脑损伤患者血清E神经元特异性烯醇化酶(NSE)、脑氧摄取率(CEO2)及预后的影响. 方法:70例重型颅脑损伤的患者为研究对象,随机分为常规骨瓣减压手术组(对照组)35例与标准大骨瓣减压手术组(实验组)35例,检测对比两组患者术前及术后1、4、7 d的血清 NSE 、脑氧摄取率(CEO2);随访12个月,应用格拉斯哥预后(GOS) 分级评价两组患者的预后. 结果: 术前两组患者的血清NSE、CEO2差异无统计学意义 (P>0.05); 两组血清NSE与CEO2在术后第1 d均有升高,但两组差异无统计学意义(P>0.05);术后第4、7 d NSE在两组均进行性降低,实验组均显著低于对照组(P<0.05);术后4 d两组CEO2均降低,对照组显著低于实验组(P<0.05),术后7 d两组CEO2均上升,对照组显著低于实验组(P<0.05);随访12个月实验组有效率优于对照组患者,差异有统计学意义(P<0.05). 结论:与常规骨瓣减压手术相比,标准大骨瓣减压对重型颅脑损伤患者的血清NSE表达、脑氧摄取率均具有改善作用,可以更好的改善患者预后.
목적:탐토표준대골판감압대중형로뇌손상환자혈청E신경원특이성희순화매(NSE)、뇌양섭취솔(CEO2)급예후적영향. 방법:70례중형로뇌손상적환자위연구대상,수궤분위상규골판감압수술조(대조조)35례여표준대골판감압수술조(실험조)35례,검측대비량조환자술전급술후1、4、7 d적혈청 NSE 、뇌양섭취솔(CEO2);수방12개월,응용격랍사가예후(GOS) 분급평개량조환자적예후. 결과: 술전량조환자적혈청NSE、CEO2차이무통계학의의 (P>0.05); 량조혈청NSE여CEO2재술후제1 d균유승고,단량조차이무통계학의의(P>0.05);술후제4、7 d NSE재량조균진행성강저,실험조균현저저우대조조(P<0.05);술후4 d량조CEO2균강저,대조조현저저우실험조(P<0.05),술후7 d량조CEO2균상승,대조조현저저우실험조(P<0.05);수방12개월실험조유효솔우우대조조환자,차이유통계학의의(P<0.05). 결론:여상규골판감압수술상비,표준대골판감압대중형로뇌손상환자적혈청NSE표체、뇌양섭취솔균구유개선작용,가이경호적개선환자예후.
To explore the influence of standard big bone flap decompression on serum levels of neuron-specific enolase (NSE), cerebral extraction rate of oxygen (CEO2), and prognosis in patients with severe head injury. Methods: 70 cases with severe head injury were randomly divided into two groups: conventional bone disc decompression surgery group (control group) 35 cases and the standard big bone flap decompression surgery group (the treatment group) 35 patients. Serum levels of NSE and CEO2 at preoperation and at day 1, 4,and 7 post surgery were measured and compared. Patients were followed up for 12 months, and their prognosis was evaluated by Glasgow Outcome Scale (GOS). Results: There was no difference between the two groups in serum levels of NSE and CEO2 at preoperation (P> 0.05). CEO2 and Serum levels of NSE at day 1 post surgery were higher than and preoperation, but did not reach statistical significance (P> 0.05). Serum levels of NSE at day 4 and 7 post surgery showed a progressive significant reduction in experimental group than those in the control group(P< 0.05). CEO2 at day 4 post surgery showed significant reduction in two experimental group than those in the control group (P < 0.05). CEO2 at day 7 post surgery showed significant increase in experimental group than those in control group (P < 0.05). After the 12-month follow-up,the prognosis in the experimental group is much better than that in the control group (P < 0.05). Conclusion: Compared with the con ventional bone disc decompression surgery, the standard big bone flap decompression surgery can improve the expression of NSE and brain oxygen uptake rate,leading to improved prognosis in patients with severe head injury.