文章摘要

标准外伤大骨瓣开颅术联合亚低温治疗对重型颅脑外伤的患者疗效、免疫功能及预后的影响

作者: 1张静, 2徐伟才, 3徐叶萍, 1焦薇
1 联勤保障部队第904医院护理部,江苏 无锡 214044
2 联勤保障部队第904医院卫勤处,江苏 无锡 214044
3 联勤保障部队第904医院神经外科,江苏 无锡 214044
通讯: 焦薇 Email: 4273187@qq.com
DOI: 10.3978/j.issn.2095-6959.2021.05.017
基金: 无锡市卫健委科技成果与适宜技术推广项目(T202016)。

摘要

目的:分析重型颅脑外伤应用标准外伤大骨瓣开颅术联合亚低温治疗的临床效果。方法:选取2019年1月至2020年10月收治的重型颅脑外伤患者80例,按照随机数字表法分组,对照组采用标准外伤大骨瓣开颅术治疗,研究组在此基础上加用亚低温治疗,比较两组治疗效果。结果:研究组治疗后总有效率(95%)高于对照组(75%),差异有统计学意义(P<0.05);治疗后两组CD4+、CD8+、CD4+/CD8+指标均有改善,研究组情况优于对照组,差异有统计学意义(P<0.05);治疗后研究组IL-6、TNF-α水平低于对照组,差异有统计学意义(P<0.05)。研究组并发症发生率7.50%,低于对照组的27.50%,差异有统计学意义(P<0.05)。结论:标准外伤大骨瓣开颅术治疗的同时应用亚低温治疗,能够有效提升患者治疗效果,降低患者炎症因子水平,改善患者免疫功能,降低患者并发症风险,从而改善患者预后。
关键词: 大骨瓣开颅术;重型颅脑外伤;免疫功能;亚低温治疗;疗效

Effect of standard trauma craniotomy combined with mild hypothermia on the efficacy, immune function, and prognosis of patients with severe traumatic brain injury

Authors: 1ZHANG Jing, 2XU Weicai, 3XU Yeping, 1JIAO Wei
1 Department of Nursing, 904 Hospital of Joint Logistics Support Force of Chinese PLA, Wuxi Jiangsu 214044, China
2 Department of Medical Service, 904 Hospital of Joint Logistics Support Force of Chinese PLA, Wuxi Jiangsu 214044, China
3 Department of Neurosurgery, 904 Hospital of Joint Logistics Support Force of Chinese PLA, Wuxi Jiangsu 214044, China

CorrespondingAuthor: JIAO Wei Email: 4273187@qq.com

DOI: 10.3978/j.issn.2095-6959.2021.05.017

Foundation: This work was supported by the Science and Technology Achievements and Appropriate Technology Promotion Project of Wuxi Municipal Health Commission, China (T202016).

Abstract

Objective: To analyze the clinical effect of standard trauma craniotomy combined with mild hypothermia treatment for severe head trauma. Methods: A total of 80 patients with severe traumatic brain injury admitted from January 2019 to October 2020 were selected and grouped by random number table. The control group was treated with standard trauma craniotomy. On this basis, the study group added sub-low temperature treatment. Treatment effects of the 2 groups were compared. Results: The total effective rate (95%) of the study group after treatment was higher than that of the control group (75%), and the difference was statistically significant. After treatment, the CD4+, CD8+, and CD4+/CD8+ indicators of the 2 groups improved, and the study group was better than the control group. The difference was statistically significant (P<0.05); after treatment, the levels of IL-6 and TNF-α in the study group were lower than those of the control group, and the difference was statistically significant (P<0.05). The complication rate of the study group was 7.50%, which was lower than that of the control group (27.50%), and the difference was statistically significant (P<0.05). Conclusion: In addition to standard trauma craniotomy, the application of mild hypothermia can effectively improve the treatment effect of patients, reduce the level of inflammatory factors, improve the immune function of patients, reduce the risk of complications, and improve the prognosis of patients.
Keywords: large bone flap craniotomy; severe head trauma; immune function; mild hypothermia treatment; curative effect