临床误诊误治2023，Vol.36Issue(8)：67-71,5.DOI:10.3969/j.issn.1002-3429.2023.08.014
着力部位EH、SDH单侧清除术联合DC对重型颅脑损伤的效果观察
Effect of Unilateral Removal of EH and SDH in the Focus Area Combined with DC on Severe Traumatic Brain Injury
摘要
Abstract
Objective To investigate the effects of unilateral removal of epidural hematoma(EH)and subdural he-matoma(SDH)in the focus area combined with decompressive craniotomy(DC)on intracranial hemodynamics and short-term prognosis in patients with severe traumatic brain injury(sTBI).Methods In total,201 patients with sTBI treated from June 2018 to October 2022 were selected as the research subjects,and were divided into observation group(unilateral removal of EH and SDH in the focus area combined with DC treatment,n =107)and control group(unilateral temporal frontal hematoma removal combined with DC treatment,n =94)according to different treatment methods.The postoperative clinical efficacy,intracranial hemodynamic indexes[middle cerebral artery peak systolic flow velocity(Vs),mean blood flow velocity(Vm),and pulse index(PI)],Glasgow coma score(GCS),optic nerve sheath diameter(ONSD),short-term prognosis and postop-erative complication rate were compared between the two groups.Results The total effective rate of the observation group(95.33%,102/107)was higher than that of the control group(85.11%,80/94)(P＜0.05).After operation,Vs and Vm were increased and PI was decreased in both groups(P＜0.05).The levels of Vs and Vm in the observation group were high-er than those in the control group,while PI was lower than that in the control group(P＜0.01).After operation,ONSD was shortened in both groups,which was shorter er in the observation group than in the control group(P＜0.01).After opera-tion,GCS scores in both groups were higher than those before operation,which were higher in the observation group than in the control group(P＜0.01).The excellent and good rate of prognosis in the observation group was higher than that in the control group at 1 month after operation,and the total incidence of postoperative complications was lower than that of the con-trol group(P＜0.01).Conclusion Unilateral removal of EH and SDH in the focus area combined with DC can improve intracra-nial hemodynamic indexes and short-term prognosis of sTBI patients,and reduce the incidence of postoperative complications.关键词
颅脑损伤/血肿清除术/去骨瓣减压术/搏动指数/格拉斯哥昏迷量表/视神经鞘直径/预后/手术后并发症Key words
Traumatic brain injury/Hematoma removal/Decompressive craniectomy/Pulsation index/Glasgow co-ma score/Optic nerve sheath diameter/Prognosis/Postoperative complication分类
临床医学引用本文复制引用
牛志成,袁静,张岚琦,刘俊,张煜..着力部位EH、SDH单侧清除术联合DC对重型颅脑损伤的效果观察[J].临床误诊误治,2023,36(8):67-71,5.基金项目
安徽省卫生健康委科研重点项目(AHWJ2021a038) （AHWJ2021a038）
