药物保守治疗与后颅窝减压手术治疗原发性脑干损伤的疗效对比

发布时间：2018-06-16 05:42

本文选题：原发性脑干损伤 + 药物保守治疗　；参考：《中国药业》2016年21期

【摘要】：目的探讨原发性脑干损伤的临床特点并对比后颅窝减压术与药物保守治疗的疗效。方法收集2012年3月至2015年2月医院神经外科住院诊治的47例原发性脑干损伤患者的临床资料,并进行回顾性分析。47例患者分为两组,其中手术组(采取开颅后颅窝减压术)18例,对照组(予以药物保守治疗,未行手术)29例。结果采用格拉斯哥预后评分(GOS评分)判断伤后1年患者总体的预后状况,10例恢复良好,6例轻度残疾,8例重度残疾,4例植物生存,19例死亡;手术组恢复良好7例、死亡4例,对照组恢复良好3例、死亡15例,与对照组相比,手术组患者恢复良好的比例较高(P=0.030),死亡率较低(χ~2=4.014,P=0.047)。结论原发性脑干损伤患者病情危重,并发症较多,死亡率极高,及时采取后颅窝减压术治疗、阻止脑干功能进行性恶化,较单纯药物保守治疗对于提高患者生存率及改善预后具有更重要的积极意义。
[Abstract]:Objective to investigate the clinical features of primary brain stem injury and to compare the curative effect of posterior cranial fossa decompression with drug conservative treatment. Methods from March 2012 to February 2015, 47 patients with primary brain stem injury were collected and analyzed retrospectively. The patients were divided into two groups, including 18 patients with craniotomy and 18 patients with craniotomy. Control group (drug conservative treatment, 29 cases without operation. Results Glasgow prognosis score (GOS) was used to evaluate the overall prognosis of 10 patients with good recovery, 6 patients with mild disability, 8 patients with severe disability, 4 patients with vegetative survival, 19 patients with vegetative survival, 7 patients with good recovery and 4 patients with death. In the control group, 3 cases recovered well and 15 cases died. Compared with the control group, the rate of good recovery in the operation group was higher than that in the control group (P 0.030), and the mortality rate was lower (蠂 ~ (2 / 2) 4.014) / P ~ (0.047). Conclusion the patients with primary brain stem injury are seriously ill, have more complications and have a high mortality rate. We should take decompression of posterior cranial fossa in time to prevent the progressive deterioration of brain stem function. Conservative drug therapy is more important to improve survival rate and prognosis.
【作者单位】：川北医学院附属医院神经外科;
【基金】：四川省南充市科技局项目,项目编号:14A0040
【分类号】：R651.15

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