标准大骨瓣减压术在重型颅脑损伤中的应用  

Application of standard large trauma craniotomy in severe craniocerebral injury

作　　者：董永尧[1] 石祥飞 张宗胜[1] 陈大全[1] 

机构地区：[1]江苏省邳州市人民医院神经外科,江苏邳州221300

出　　处：《中国医药科学》2016年第24期161-163,203,共4页China Medicine And Pharmacy

摘　　要：目的探讨标准大骨瓣减压术治疗重型颅脑损伤的临床疗效。方法选择2013年1月-2015年12月在我院治疗的重型颅脑损伤患者80例的临床资料进行回顾性分析。根据治疗方法分组。其中40例患者采用常规骨瓣减压术治疗为对照组,40例患者采用标准大骨瓣减压术治疗为研究组。比较两组治疗前后颅内压水平,随访6个月,比较两组预后,比较两组并发症发生率。结果术后两组颅内压均较术前显著下降,差异有统计学意义（P〈0.05）。术后第1天、第3天及第5天研究组患者颅内压水平均显著低于对照组,差异有统计学意义（P〈0.05）。对照组死亡率显著高于研究组,研究组预后良好率显著高于对照组,差异均有统计学意义（P〈0.05）。两组脑脊液漏、迟发性血肿、急性脑膨出、颅内感染以及癫痫的发生率差异无统计学意义（P〉0.05）。结论重型颅脑损伤采用标准大骨瓣减压术治疗能够显著改善预后,并且不增加并发症的发生率。Objective To discuss application of standard large trauma craniotomy in severe craniocerebral injury. Methods Clinical data of 80 cases with severe craniocerebral injury from Jan 2013 to Dec 2015 were retrospectively analyzed. All cases were grouped according to treatment method. 40 cases of control group were treated with conventional bone flap decompression, and 40 cases of study group were treated with standard large trauma craniotomy. Intracranial pressure before and after treatment of two groups was compared. Followed-up for 6 months, prognosis and complication rates of two groups were compared. Results Intracranial pressure after treatment of two groups were lower than those before treatment, which showed significant difference（P 〈 0.05）. Intracranial pressure levels at the first day, the third day and the fifth day of study group were lower than control group, which showed significant difference（P 〈 0.05）. Mortality rate of control group was higher than study group, and good prognosis of study group was higher than control group, which showed significant difference（P 〈 0.05）. Cerebrospinal fluid leakage, delayed hematoma, acute encephalocele, intracranial infection and the incidence of epilepsy of two groups showed no significant difference（P 〉 0.05）. Conclusion Standard large trauma craniotomy in severe craniocerebral injury can improve clinical efficacy, but does not increase the incidence of complications.

关 键 词：标准大骨瓣减压术 重型 颅脑损伤 

分 类 号：R651.1[医药卫生—外科学]