标准大骨瓣开颅治疗重度颅脑损伤继发急性硬膜下血肿疗效分析  

Curative effect analysis of standard large craniotomy treatment for patients with severe traumatic brain injury secondary to acute subdural hematoma

作　　者：方晖[1] 陈新生[1] 施正生[1] 

机构地区：[1]安徽安庆市立医院神经外科,安庆246003

出　　处：《中国实用神经疾病杂志》2014年第18期18-20,共3页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨重度颅脑损伤继发急性硬膜下血肿患者应用标准大骨瓣开颅手术治疗的临床效果及安全性。方法选取我科2011-12—2014-01重度颅脑损伤继发急性硬膜下血肿患者50例,随机分为常规组和观察组各25例,常规组实施常规骨瓣开颅手术治疗,观察组实施标准大骨瓣开颅手术治疗,对比2组患者术前及术后不同时间点的血肿量、治疗效果,以及随访过程中患者术后并发症的发生情况。结果观察组术后1d、3d、7d血肿量分别低于常规组患者同时间点的血肿量;观察组有效率67.50%,常规组有效率37.50%,观察组效果明显更好;观察组病死率2.50%,明显低于常规组17.50%;观察组颅内感染、硬脑膜下积液、迟发性血肿、切口脑脊液漏、急性脑膨出发生率均低于常规组,差异有统计学意义;脑梗死发生率2组对比差异无统计学意义。结论对重度颅脑伤继发急性硬膜下血肿患者应用标准大骨瓣开颅手术治疗临床效果确切,且安全性高,值得临床推广应用。Objective To investigate the curative effect analysis of standard large craniotomy treatment for patients with severe traumatic brain injury secondary to acute subdural hematoma.Methods 50 cases of patients with severe traumatic brain injury secondary to acute subdural hematoma were randomly divided into the conventional group（n=25）and the observation group（n=25）.The conventional group was treated with conventional craniotomy surgery,and The observation group was treated with standard large craniotomy.And then we compared the hematoma volume in different time points and clinical curative effect in two groups before and after operation.We also observed the complications of two groups after operation.ResultsThe hematoma volume and fatality rate in the observation group were lower than these in the conventional group,however the treatment efficiency of observation group was higher than that of conventional group at 1d,3dand 7dafter operation;The incidence rates of intracranial infection,subdural effusion,delayed hematoma,wound cerebrospinal fluid leakage and acute encephalocele in the observation group were lower than these in the conventional group.There was no significant difference in cerebral infarction incidence of two groups.Conclusion There is more clinic curative effect and security for patients with severe traumatic brain injury secondary to acute subdural hematoma treated with standard large craniotomy.

关 键 词：重度颅脑损伤 继发急性硬膜下血肿 标准大骨瓣开颅手术 安全性 

分 类 号：R651.15[医药卫生—外科学]