【摘要】 目的探讨脑池造瘘术并脑脊液引流治疗重度颅脑创伤(s TBI)的临床研究。方法选取普宁市人民医院神经外科从2018年1月～2019年12月住院治疗的62例s TBI患者作为研究对象,其中去骨瓣组有31例患者和脑池造瘘术并脑脊液引流组有31例患者。比较两组患者ICU时间、住院时间、死亡率、出院时GCS及随访3个月的格拉斯哥预后评分(GOS)。结果两组患者ICU时间、住院时间及死亡率比较,差异无统计学意义(P> 0.05)。脑池造瘘术并脑脊液引流组患者出院时的GCS高于去骨瓣组(P <0.05)。3个月后随访采用GOS进行评价,脑池造瘘术并脑脊液引流组预后良好24例高于去骨瓣组14例(P <0.05)。结论脑池造瘘术并脑脊液引流能重建s TBI患者的脑脊液循环,改善病理性颅内高压,对术后s TBI患者的神经功能恢复具有积极的意义。更多还原

【Abstract】 Objective To investigate the clinical research of cistern fistulation combined with cerebrospinal fluid drainage in the treatment of severe traumatic brain injury(sTBI). Methods 62 sTBI patients admitted to and treated in the neurosurgery department of Puning People’s Hospital from January 2018 to December 2019 were selected as the research objects and were divided into the bone flap removal group(n=31) and the cistern fistulation combined with cerebrospinal fluid drainage group(n=31).The ICU time,hospitalization time,mortality rate,GCS at discharging time and Glasgow outcome scale(GOS) after 3 months’ follow-up were compared between the two groups. Results There were no statistically significant differences in ICU time,hospitalization time and mortality rate between the two groups(P > 0.05).The GCS at discharging time of patients in the cistern fistulation combined with cerebrospinal fluid drainage group was higher than that in the bone flap removal group(P < 0.05).The follow-up after 3 months was evaluated by GOS.The number of cases with fine prognosis in the cistern fistulation combined with cerebrospinal fluid drainage group was 24,higher than 14 cases of the bone flap removal group(P < 0.05). Conclusion Cistern fistulation combined with cerebrospinal fluid drainage can reconstruct cerebrospinal fluid circulation of sTBI patients,improve pathological intracranial hypertension,which is of positive significance for the recovery of neurological function of sTBI patients after operation.更多还原