目的 研究颅内压(ICP)监测联合浮动骨瓣减压术在治疗颅脑损伤中对颅内压及脑血流指标的影响。方法 选取我院2019年3月—2021年3月收治的拟行骨瓣减压术的颅脑损伤患者106例作为研究对象,按照手术方法不同分为对照组(n＝53)、观察组(n＝53)。对照组采用传统去骨瓣减压术(DC)治疗,观察组采用ICP监测联合浮动骨瓣减压术治疗。对比2组ICP、脑血流指标[平均流速(Vm)、收缩期血流速度(Vs)、血管搏动指数(PI)]及并发症发生情况。结果 术后1、3、7 d观察组ICP、PI低于对照组,Vm、Vs高于对照组(P＜0.05);术后观察组并发症总发生率9.43%低于对照组37.74%(P＜0.05)。结论 采用ICP监测联合浮动骨瓣减压术治疗颅脑损伤能降低患者ICP,改善脑血流状态,降低术后并发症,避免二次手术,减轻患者经济负担。

Objective To study the effect of intracranial pressure (ICP) monitoring combined with floating bone flap decompression on intracranial pressure and cerebral blood flow index in the treatment of craniocerebral injury. Methods A total of 106 patients admitted to our hospital from March 2019 to March 2021 were selected as study subjects and divided into control group (n=53) and observation group (n=53).The control group was treated with traditional decompressed craniectomy (DC), and the observation group was treated with ICP monitoring combined with floating bone flap decompression.The ICP, cerebral blood flow index [mean flow velocity (Vm), systolic flow velocity (Vs), vascular pulsatility index (PI)] and complications were compared between the two groups. Results ICP and PI were lower in observation groups on 1,3 and 7 d, Vm and Vs were higher (P <0.05); the incidences of complications in observation group (9.43%), such as electrolyte disorder, pulmonary infection, abnormal renal function and incisional hernia, were lower in the control group (37.74%, P<0.05). Conclusions ICP monitoring combined with floating bone flap decompression could reduce ICP, improve cerebral blood flow, reduce postoperative complications, avoid secondary surgery and reduce economic burden.

目的 观察控制性减压术对重型颅脑损伤患者神经功能、颅内压及预后的影响。方法 将我院2016年3月—2017年2月治疗的94例重型颅脑损伤患者作为研究对象,入选者均依据随机数表法分为两组,各47例。对照组实施大骨瓣减压术,观察组实施控制性减压术。观察手术前后两组神经功能、颅内压及预后等。结果 术前2组神经行为认知状态检查表(NCSE)评分、颅内压对比,差异无统计学意义(P＞0.05);术后观察组NCSE评分高于对照组,颅内压低于对照组,差异有统计学意义(P＜0.05);2组预后等级相比,观察组优于对照组,差异有统计学意义(P＜0.05)。结论 将控制性减压术应用于重型颅脑损伤患者中降颅内压效果良好,可恢复受损神经功能,提升患者康复效果,改善预后。