带肌蒂颅脑修复成形术联合NGF经鼻脑靶向治疗颅脑损伤临床观察Clinical observation of muscle-pedicled craniocerebral repair combined with NGF naso-cerebral targeted therapy craniocerebral injury
高玉帅;步星耀;闫兆月;孙勇;禹金良;盛致远;
摘要(Abstract):
目的探讨带肌蒂颅脑修复成形术联合神经生长因子(NGF)经鼻脑靶向治疗对颅脑损伤患者的脑血流变化及神经功能恢复的影响。方法颅脑损伤术后颅骨缺损患者116例,随机分为对照组56例和观察组60例,2组均行带肌蒂颅脑修复成形手术治疗,观察组在对照组的基础上给予NGF经鼻腔滴注,对损伤脑组织靶向神经营养修复治疗。应用CT脑灌注及FIM评分、GOS评分来评估治疗后2组脑血流循环及神经功能的改善情况。结果治疗后2组缺损侧皮质区CBF(71.90±12.38)、CBV(8.65±1.73)分别较治疗前CBF(60.37±13.03)、CBV(6.86±1.82)显著增加(P<0.01);两侧基底节区和丘脑相关区域治疗后较治疗前脑血流灌注相关数值均有所增加,但差异无统计学意义(P>0.05);治疗后3个月观察组FIM评分、GOS评分明均显高于对照组(P<0.01)。结论带肌蒂颅脑修复成形术联合NGF经鼻脑靶向治疗颅脑损伤,恢复了颅腔内环境和颅内压力的稳态,显著增加了缺损侧的脑血流灌注,促进了神经功能的恢复。
关键词(KeyWords): 颅脑损伤;颅脑修复;神经生长因子;经鼻脑靶向;宝石CT脑灌注
基金项目(Foundation): 河南大学教育发展基金(编号:2019004)
作者(Authors): 高玉帅;步星耀;闫兆月;孙勇;禹金良;盛致远;
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