中国现代医学杂志2026，Vol.36Issue(12)：94-100,7.DOI:10.3969/j.issn.1005-8982.2026.12.014
改良去骨瓣减压术治疗重型创伤性脑损伤的临床疗效研究
Clinical efficacy of modified decompressive craniectomy in severe traumatic brain injury
摘要
Abstract
Objective To investigate the clinical efficacy of modified decompressive craniectomy in patients with severe traumatic brain injury.Methods A total of 90 patients with severe traumatic brain injury who received treatment in the Department of Critical Care Surgery of the First Affiliated Hospital of Henan University of Science and Technology from January 2023 to December 2025 were enrolled.They were divided into an experimental group(modified decompressive craniectomy)and a control group(conventional decompressive craniectomy)according to the surgical method,with 45 cases in each group.The two groups were compared in terms of intracranial pressure(ICP),cerebral hemodynamics[maximum systolic velocity(Vs),pulsatility index(PI)of bilateral internal carotid arteries,mean flow velocity(Vm)],serum cytokine levels[high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),interleukin-10(IL-10),neuron-specific enolase(NSE),S100 calcium-binding protein B(S-100β)],cognitive function[Mini-Mental State Examination(MMSE)score],postoperative complications,and prognosis[extended Glasgow outcome scale(GOSE)score].Results ICP comparisons between the experimental and control groups before surgery and at 1 and 3 days after surgery showed that there were statistically significant differences in ICP across different time points(P＜0.05)and between the two groups(P＜0.05),with lower ICP observed in the experimental group at 1 and 3 days after surgery compared with the control group.The trends of ICP changes over time differed significantly between the two groups(P＜0.05).At 7 days after surgery,the experimental group showed significantly higher Vs and Vm,and significantly lower PI and hs-CRP,IL-6,IL-10,NSE,and S-100βlevels compared with the control group(P＜0.05).At 7 days postoperatively,Vs and Vm were significantly higher,while PI and hs-CRP,IL-6,IL-10,NSE,and S-100β levels were significantly lower than preoperative values in both groups(P＜0.05).At 2 weeks after surgery,scores of instantaneous memory,short-term memory,language ability,orientation,visuospatial function,and attention/calculation were significantly higher in the experimental group than in the control group(P＜0.05).The overall incidence of postoperative complications was significantly lower in the experimental group than in the control group(P＜0.05).The favorable prognosis rate at 3 months after surgery was significantly higher in the experimental group than in the control group(P＜0.05).Conclusion In patients with severe traumatic brain injury,modified decompressive craniectomy effectively alleviates intracranial hypertension,improves cerebral blood flow and hemodynamic status,reduces inflammatory responses,decreases levels of neurological injury biomarkers,enhances cognitive function and prognosis,and reduces postoperative complications.关键词
重型创伤性脑损伤/改良去骨瓣减压术/炎症因子/扩展格拉斯哥预后评分Key words
severe traumatic brain injury/modified decompressive craniectomy/inflammatory factors/extended Glasgow outcome scale score分类
医药卫生引用本文复制引用
张攀,宫一柯,史保中,赵林海..改良去骨瓣减压术治疗重型创伤性脑损伤的临床疗效研究[J].中国现代医学杂志,2026,36(12):94-100,7.基金项目
河南省医学科技攻关计划联合共建项目(LHGJ20232800) （LHGJ20232800）
