标准外伤大骨瓣开颅术对重型颅脑损伤的疗效分析  

Efficacy of standard large trauma craniotomy on severe traumatic brain injury

作　　者：李传友[1] 毛青[2] 

机构地区：[1]河南省新乡市中心医院神经外一科,453000 [2]上海交通大学医学院附属仁济医院神经外科,200127

出　　处：《重庆医学》2013年第19期2206-2207,2211,共3页Chongqing medicine

基　　金：国家自然科学基金资助项目(81071542)

摘　　要：目的探讨标准外伤大骨瓣开颅术在重型颅脑损伤的临床应用价值。方法选择2008年6月至2011年6月该院112例重型颅脑损伤患者,采用常规骨瓣开颅减压术的患者为对照组(n=56),采用美国标准标准外伤大骨瓣开颅术的患者为治疗组(n=56),比较两组手术治疗后的临床疗效。结果治疗组共10例发生并发症,发生率为17.86%;对照组共24例发生并发症,发生率为42.86%。两组间差异有统计学意义(P<0.01)。治疗组手术后良好31例,轻残11例,重残5例,植物生存2例,死亡7例;对照组手术后良好13例,轻残19例,重残9例,植物生存5例,死亡10例;两组临床疗效比较,差异有统计学意义(P<0.05)。治疗组术后第3天、术后第7天的颅内压与对照组相比,差异均有统计学意义(P<0.05)。结论标准外伤大骨瓣开颅术治疗重型颅脑损伤具有较好的临床疗效,且不良反应少、减压充分,值得临床推广运用。Objective To investigate the clinical value of standard large trauma craniotomy in severe traumatic brain injury.Methods A total of 112 cases of severe head injury patients in our hospital from June 2008 to June 2011 were chosen as object for study,and were randomly divided into two groups,the control group（n=56） underwent conventional craniotomy decompression,the treatment group（n=56） underwent American standard of large trauma craniotomy,surgical treatment and clinical efficacy in two groups were compared.Results In the treatment group,a total of 10 cases were with complications,the occurrence rate was 17.86%;in the control group,total 24 patients had complications,the occurrence rate was 42.86%.The result of complication rate in two groups showed significant difference（P0.05）.31 cases had good result post-operative treatment in the treatment group,11 cases were mild disability,5 cases were severe disability,two cases were vegetable being,7 cases died;while 13 cases had good result in the control group after surgery,19 cases were mild disability,9 cases were severe disability,5 cases were vegetable being and 10 cases died;clinical efficacy by comparing the difference was statistically significant（P0.05）.After 3,7 days,comparing the intracranial pressure between the control group and the treatment group,the difference was statistically significant（P0.05）.Conclusion The standard large trauma craniotomy for treatment of severe traumatic brain injury has better clinical efficacy and fewer adverse reactions,full decompression,worthy of clinical use.

关 键 词：颅脑损伤 标准外伤大骨瓣开颅术 疗效 

分 类 号：R651.15[医药卫生—外科学]