摘要
Abstract
Objective:To investigate the effect of stepwise decompression under intracranial pressure monitoring in the treatment of severe craniocerebral injury.Method:The clinical data of 80 patients with severe craniocerebral injury who were admitted to Shangrao People's Hospital from January 2021 to December 2024 were retrospectively collected.The patients were divided into stepwise decompression group(n=41)and conventional group(n=39)according to different surgical methods.The conventional group was treated with conventional evacuation of hematoma by craniotomy and decompressive craniectomy,while the stepwise decompression group was treated with stepwise decompression under intracranial pressure monitoring on the basis of the treatment in conventional group.All patients were followed up for 3 months after surgery.Surgery-related indicators,intracranial pressure,cerebral oxygen metabolism,neurological function,and cognitive function were compared between the two groups.Postoperative adverse reactions and prognosis were statistically analyzed.Result:The duration of surgery in the stepwise decompression group was longer than that in the conventional group,while the total hospital stay was shorter,the intraoperative blood loss was less in the stepwise decompression group compared to the conventional group(P<0.05).Immediately after the operation,at 6 and 12 hours after the operation,the intracranial pressure in both groups decreased,and those of the stepwise decompression group were significantly lower than those of the conventional group(P<0.05).Three days after operation,jugular venous oxygen saturation(SjvO2),O2 content of mixed blood(CvO2)and cerebral oxygen extraction rate(CERO2)in the stepwise decompression group were higher than those in the conventional group(P<0.05).One month and 3 months after surgery,the NIHSS scores of the stepwise decompression group were lower than those of the conventional group,and the Glasgow coma scale(GCS)scores were higher than those of the conventional group(P<0.05).There was no statistically significant difference in the incidence of postoperative adverse reactions between the two groups(P>0.05).Three months after surgery,the Glasgow outcome scale(GOS)score of the stepwise decompression group was higher than that of the conventional group(P<0.05).Conclusion:Stepwise decompression under intracranial pressure monitoring can effectively promote recovery,reduce intracranial pressure,and improve cerebral oxygen metabolism,neurological function,cognitive function and the prognosis in patients with severe craniocerebral injury.关键词
颅内压监测/阶梯减压/颅脑损伤/去骨瓣减压术/神经功能Key words
Intracranial pressure monitoring/Stepwise decompression/Craniocerebral injury/Decompressive craniectomy/Neurological function
