两种手术方式治疗重症颅脑损伤临床效果分析  

Clinical analysis of the two surgical treatment of severe brain injury

作　　者：吴贵平[1] 曾鹏[1] 钟俊贤[1] 沙龙金[1] 曾文胜[1] 王广斌[1] 

机构地区：[1]中山大学附属东华医院,广东东莞523110

出　　处：《中国中医药咨讯》2012年第4期62-63,共2页

摘　　要：目的探讨两种手术方式治疗重症颅脑损伤患者的临床疗效。方法对我院收治的105例重症颅脑损伤患者临床资料进行回顾性分析，其中54例采用大骨瓣减压术进行手术治疗（观察组），51例采用传统开颅血肿清除术联合去骨瓣减压术治疗附照组），比较两组患者临床治疗效果。结果观察组格拉斯哥预后评价（GOS），良好25例，中残16例，重残8例，植物状态5例，死亡0例；对照组格拉斯哥预后评价（COS），良好9例，中残14例，重残15例，植物状态10例，死亡3例；观察组格拉斯哥预后评价中良好、中残明显高于对照组，重残、植物状态、死亡明显低于对照组，两组比较差异有统计学意义（P〈0．05）。观察组生活质量评分优、良比例明显高于对照组，且中、差、极差比例明显低于对照组，两组比较差异均有统计学意义，（P〈0．05）。结论大骨瓣减压术治疗重症颅脑损伤患者疗效显著，预后良好，是治疗重症颅脑损伤较为有效的方法，值得临床推广应用。Objective Explore the clinical efficacy of two surgical methods in the treatment of severe traumatic brain injury patients.Methods The clinical data of 105 cases of severe traumatic brain injury patients admitted to our hospital were retrospectively analyzed, of which 54 cases of hemicraniectomy for surgical treatment （observation group）, 51 cases using the traditional hematoma evacuation joint craniectomydecompression for the treatment （control group）, comparing two groups of patients with clinical treatment. .Results Good observation group Glasgow prognosis evaluation （GOS）, 25 cases in the residual 16 cases, heavy residues 8 cases, 5 cases of vegetative state, 0 cases of death; control group Glasgow prognosis evaluation （GOS）, a good nine cases, the residual 14 cases,15 cases of severe disability, vegetative state 10 cases, three cases of death; good Glasgow prognostic evaluation of the observation group, was significantly higher in the residual, severe disability, vegetative state, death was significantly lower than the control group, the difference was statisticallysignificance （P 〈0.05）. Observer Group of the quality of life score excellent, good proportion was significantly higher, and in poor, very poor ratio was significantly lower than the control group, the difference was statistically significant （P 〈0.05）. Conclusions The efficacy of hemicraniectomy in the treatment of severe traumatic brain injury patients were significantly good prognosis, a more effective method of treatment of severe traumatic brain injury, is worthy of clinical application.

关 键 词：重症颅脑损伤 手术治疗 大骨瓣减压术 去骨瓣减压术 

分 类 号：R651.15[医药卫生—外科学]