标准大骨瓣减压在重型颅脑损伤治疗中的应用  

Clinical application of standard large bone flap decompression for the treatment of severe craniocerebral injury

作　　者：王东生[1] 

机构地区：[1]大连医科大学附属二院神外二病房,大连116000

出　　处：《中国实用神经疾病杂志》2014年第15期5-6,共2页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨标准大骨瓣减压术治疗重型颅脑损伤的效果。方法选择2011-01—2012-12在我院采用大骨瓣减压术治疗的150例重型颅脑损伤患者作为研究对象,随机分为观察组(标准大骨瓣减压术组)76例,对照组(常规骨瓣减压术组)74例,观察2组术后颅内压控制情况及临床疗效。结果观察组术后第3、5、7天颅内压分别为(19.7±2.8)、(17.8±2.3)、(16.1±2.1)mmHg,对照组分别为(28.8±2.7)、(26.4±2.1)、(23.7±2.4)mmHg,2组相比差异有统计学意义(P<0.05)。根据GOS分级,观察组总有效率89.5%;对照组为63.5%,2组相比差异有统计学意义(P<0.05)。结论标准大骨瓣减压术治疗重型颅脑损伤的临床效果好,可有效降低颅内压,显著改善患者预后,降低病死率,是治疗重型颅脑损伤安全有效的手术方式,值得临床推广应用。Objective To observe the clinical curative effect of standard large bone flap decompression for the treatment of severe craniocerebral injury .Methods From January 2011 to December 2012 ,150 patients with large bone flap decompression for the treatment of their severe craniocerebral injury were selected as the research objects in our hospital .They were randomly divided into observation group （standard large bone flap decompression group ,n=76） and control group （conventional large bone flap decompression group ,n=74） ,the situations of intracranial pressure control were observed and the improvement of clinical effect was evaluated according to GOS grading and the comprehensive analysis was made .Results The situation of in-tracranial pressure control after surgery ：the intracranial pressure in the 3rd , 5th , and 7th day were （19 .7 ± 2 .8 ） , （17 .8 ± 2 .3）and （16 .1 ± 2 .1） mmHg ,respectively in observation group .In the control group ,the data were （28 .8 ± 2 .7） , （26 .4 ± 2 .1） and （23 .7 ± 2 .4） mmHg ,respectively ,when compared in the two groups ,there were significant differences in statistics （P〈0 .05） .The improvement of clinical effect after surgery ：according to the GOS ratings ,there were 33 cases re-covered well ,23 cases with medium disabilities ,12 cases were severe disabilities ,2 cases were plant survival ,6 cases were dead ,the total effective rate was 89 .5% in observation group ;there were 20 cases recovered well ,15 cases with medium disa-bilities ,12 cases were severe disabilities ,6 cases were plant survival ,21 cases were dead ,the total effective rate was 63 .5% in control group;when compared between the two groups ,there were significant differences in statistics （P〈0 .05） .Conclusion The effectiveness of standard large bone flap decompression for the treatment of severe craniocerebral injury is better .It can decrease intracranial pressure effectively ,improve the prognosis of patients significantly and reduce the death rate .It ma

关 键 词：标准大骨瓣减压 重型颅脑外伤 

分 类 号：R651.11[医药卫生—外科学]