超早期钻孔引流加气管插管过度通气治疗急性硬膜下血肿合并脑疝的疗效观察

目的观察超早期钻孔引流加气管插管过度通气治疗急性硬膜下血肿合并脑疝的临床效果。方法 60例急性硬膜下血肿合并脑疝患者随机分为观察组和对照组,各30例。2组均给予保持呼吸道通畅、降颅内压、保护脑组织,并采取超早期钻孔引流加气管插管过度通气治疗。观察组从发现单侧或双侧脑疝症状至采取手术治疗时间≤1h,对照组治疗时间〉1h。治疗后比较2组病死率及术后功能恢复情况。结果观察组病死率为36.7%低于对照组的50.0%,差异有统计学意义（P〈0.05）;术后1级恢复率为43.3%高于对照组的26.7%,差异有统计学意义（P〈0.05）。结论及早发现病情变化,争取在脑疝发生前或脑疝早期行手术清除血肿并减压,才能进一步提高急性硬膜下血肿患者的生存质量,降低患者的病死率和伤残率。

Clinical observation of ultra-early hole drainage combined with hyperventilation endotracheal intubation in acute subdural hematoma with traumatic brain hernia

Objective To observe clinical effect of ultra-early hole drainage combined with hyperventilation endotracheal intubation in acute subdural hematoma and traumatic brain hernia.Methods 60 cases patients of acute subdural hematoma combined with traumatic brain hernia were randomly divided into observation group and control group,30 cases of each.Two groups were both given to maintain airway patency,reduce intracranial pressure,protect brain tissue,and took ultra-early hole drainage combined with hyperventilation endotracheal intubation.The therapy time from found that symptoms of unilateral or bilateral hernia surgery of observation group was ≤1h,control group 1h.After treatment,compared mortality and postoperative functional recovery of two groups.Results The mortality of observation group（36.7%）was lower than that of control group（50.0%）,the differences was statistically significant（P〈0.05）.After surgery,the first level recovery rate of observation group（43.3%）was higher than that of control group（26.7%）,the differences was statistically significant（P〈0.05）.Conclusion Early detect condition changes,for traumatic brain herni surgery before or the early traumatic brain hernia remove the hematoma and decompression,can further improve the quality of life of acute subdural hematoma,reduce mortality and disability rate of patients.