改良标准外伤大骨瓣开颅术治疗重型颅脑外伤的效果评价  

Evaluation of Modified Standard Large Trauma Craniotomy in the Treatment of Severe Traumatic Brain Injury

作　　者：金涛[1] JIN Tao(Shantou Central Hospital, Shantou 515041, China)

机构地区：[1]广东省汕头市中心医院,广东汕头515041

出　　处：《中国医学创新》2017年第6期118-121,共4页Medical Innovation of China

摘　　要：目的:探索改良标准外伤大骨瓣开颅术治疗重型颅脑外伤的效果。方法:在2012年6月-2016年6月本院收治的重型颅脑外伤患者中随机抽取出90例作为本次研究的观察对象,根据手术方法不同进行分组,对照组患者行标准外伤大骨瓣开颅术治疗,观察组患者行改良标准外伤大骨瓣开颅术治疗,对比分析两组患者的手术治疗效果。结果:观察组患者的存活率为89.13%,高于对照组的70.45%(P<0.05);观察组存活患者术后1、3、7、14 d的颅内压均比对照组患者低(P<0.05);观察组存活患者术后14 d的GOS评分高于对照组(P<0.05);观察组存活患者的再次出血、颅内感染、癫痫、脑积水、切口疝发生率分别为2.44%、4.88%、2.44%、2.44%、4.88%,均低于对照组的16.31%、22.58%、19.35%、19.35%、25.81%(P<0.05);两组切口脑脊液渗漏发生率比较,差异无统计学意义(P>0.05)。结论:改良标准外伤大骨瓣开颅术用于重型颅脑外伤效果确切,有助于提高抢救效果,减少术后并发症的发生,改善预后,值得在临床治疗中推广应用。Objective： To explore the effect of modified standard large trauma craniotomy in the treatment of severe traumatic brain injury.Method： In our hospital from June 2012 to June 2016 among the patients with severe traumatic brain injury 90 cases were randomly selected as the research objects, they were grouped according to the operation method of difference, the control group underwent standard large trauma craniotomy treatment, the observation group were treated by modified standard large trauma craniotomy, the effects of surgical treatment of two groups were analyzed.Result： The survival rate of the observation group was 89.13%, which was higher than 70.45% of the control group （ P〈0.05 ） .The observation group survival in patients with postoperative 1, 3, 7, 14 d after the intracranial pressure were lower than those of the control group （ P〈0.05 ） .The observation group survival in patients with postoperative 14 d GOS score were higher than that of the control group （ P〈0.05 ） .The observation group survival in patients with rebleeding, intracranial infection, epilepsy, hydrocephalus, the incidence of incisional hernias were 2.44%, 4.88%, 2.44%, 2.44%, 4.88%, the control group were 16.31%, 22.58%, 19.35%, 19.35%, 25.81% （P〈0.05） .The rate of cerebrospinal fluid leakage of two groups had no difference （P〉0.05） .Conclusion： Modified standard large trauma eraniotomy for severe eranioeerebral trauma and the exact effect, help to improve the rescue effect, reduce the incidence of postoperative complications, improve the prognosis, it is worthy of popularization and application in clinical treatment.

关 键 词：改良标准外伤大骨瓣开颅术 重型颅脑外伤 治疗效果 

分 类 号：R651.15[医药卫生—外科学]