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机构地区:[1]广州市中西医结合医院神经外科,广州510800 [2]南昌大学第二附属医院神经外科,南昌330006
出 处:《实用临床医学(江西)》2016年第7期36-38,41,共4页Practical Clinical Medicine
摘 要:目的探讨充分减压法在重型颅脑创伤手术治疗中的应用效果。方法将61例重型颅脑创伤患者按治疗方法不同分为2组:治疗组28例行充分减压法开颅手术;对照组33例行常规去大骨瓣减压开颅手术。术后随访6个月,采用GOS评分标准比较2组治疗效果。结果治疗组恢复良好4例(14.3%)、轻残10例(35.7%)、重残5例(17.9%)、植物状态3例(10.7%)、死亡6例(21.4%),GOS评分(3.11±0.82)分;对照组恢复良好2例(6.1%)、轻残7例(21.2%)、重残5例(15.2%)、植物状态6例(18.2%)、死亡13例(39.4%),GOS评分(2.36±0.78)分;治疗组GOS评分较对照组显著升高(P<0.05),死亡率较对照组显著下降(P<0.05)。结论在重型颅脑损伤的手术治疗中采用充分减压法可最大程度维持脑灌压、保护脑血管的自动调节功能,预防继发性脑缺血损伤,提高患者预后,降低死亡率。Objective To investigate the clinical efficacy of full decompression in surgery for severe traumatic brain injury.Methods Sixty-one patients with severe traumatic brain injury were assigned to receive either full decompression craniotomy(treatment group,n=28)or conventional decompressive craniotomy(control group,n=33).Patients were followed up for 6months and therapeutic efficacies were evaluated using Glasgow Outcome Scale(GOS).Results In treatment group,good recovery occurred in 4patients(14.3%),mild disability in 10patients(35.7%),severe disability in 5patients(17.9%),and vegetative state in 3patients(10.7%).In control group,good recovery occurred in 2patients(6.1%),mild disability in 7patients(21.2%),severe disability in 5patients(15.2%),and vegetative state in 6patients(18.2%).Compared with control group,full decompression craniotomy increased GOS score(3.11±0.82 vs 2.36±0.78,P〈0.05),and decreased mortality rate(21.4%vs 39.4%,P〈0.05).Conclusion Full decompression craniotomy can maintain the cerebral perfusion pressure,protect the cerebrovascular automatic adjustment function,prevent the secondary cerebral ischemia injury,improve the prognosis,and decrease the mortality rate in patients with severe traumatic brain injury.
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