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目的分析外伤性脑疝患者不同手术时间窗对术后出现脑梗死概率的影响。方法搜集永城市中心医院2015年1月—2017年1月诊治的139例行外伤性脑疝手术患者,根据GCS评分不同进行分组对比,分析不同手术时间窗术后脑梗死的发生率。结果 (1)GCS评分3~5分患者89例,手术时间在≤2 h组的术后脑梗死的发生率(8.9%)显著低于>2 h组(29.5%),差异有统计学意义(χ~2=6.14,P<0.05);(2)GCS评分6~8分的50例患者中,手术时间在≤3 h组发生率(11.1%)显著低于>3 h组(47.8%),差异有统计学意义(χ~2=8.30,P<0.05)。结论外伤性脑疝患者手术选择合适的手术时间窗可以有效降低术后脑梗死的发病率,手术时间窗合适时机为GCS评分3~5分≤2 h或GCS评分3~5分手术时间窗≤3 h,其术后脑梗死的发生率最低,临床价值高。
Objective To analyze the influence of different operative time windows on the probability of postoperative cerebral infarction in patients with traumatic brain hernia. Methods A total of 139 patients with traumatic brain hernia treated in Yongcheng Central Hospital between January 2015 and January 2017 were enrolled and compared with each other according to different GCS scores. The incidence of cerebral infarction after different operation time windows was analyzed. Results (1) There were 89 patients with GCS score of 3 to 5, the incidence of postoperative cerebral infarction (8.9%) was significantly lower than that of> 2 h group (29.5%), the difference was statistically significant (2) The incidence of operative time in ≤3 h group (11.1%) was significantly lower than that in> 3 h group (47.8%) in 50 patients with GCS score of 6 to 8 (χ ~ 2 = 6.14, ), The difference was statistically significant (χ ~ 2 = 8.30, P <0.05). Conclusion Surgery for patients with traumatic brain hernia can reduce the incidence of postoperative cerebral infarction by choosing appropriate time window. The suitable timing of operation time window is 3 to 5 minutes for GCS score or 2 to 3 hours for GCS score. The operative time window is less than or equal to 3 h, the incidence of postoperative cerebral infarction the lowest, high clinical value.