标准大骨瓣减压术和常规骨瓣开颅术治疗重症型颅脑损伤的疗效及对神经功能的影响  

Curative effect of standard large bone flap decompression and conventional craniotomy on severe craniocerebral injury and its effect on neurological function

作　　者：奚恩涛 XI En - tao(Department of Neurosurgery,The Liaoyang Third People＇s Hospital Liaoyang 111000 China)

机构地区：[1]辽阳市第三人民医院神经外科,辽宁辽阳111000

出　　处：《中国伤残医学》2017年第20期22-24,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的：研究重症型颅脑损伤者行标准大骨瓣减压手术和常规骨瓣开颅手术治疗对疗效、神经功能的影响.方法：分析本院2015年2月-2017年2月收治的颅脑损伤102例重症患者资料,按照临床不同治疗方案分成2组,将行常规骨瓣开颅手术治疗51例患者作为对照组,将行标准大骨瓣减压手术治疗51例患者作为观察组,对2组疗效、神经功能进行比较.结果：观察组手术后第1、2天颅内压水平21.10±2.40mmHg、19.06±2.29mmHg均比对照组30.12±2.60mmHg、27.09±2.46mmHg低,且治疗后1、2个月神经功能评分20.35±1.10分、10.20±0.50分均比对照组30.40±2.20分、18.35±2.08分低,比较差异均具有统计学意义（P〈0.05）;观察组总并发症率7.84％,比对照组23.53％低,比较差异具有统计学意义（P〈0.05）.结论：重症型颅脑损伤者行标准大骨瓣减压手术治疗能够降低其颅内压,改善患者神经功能,并减少并发症的发生,具较高推广价值.Objective： To study the effect of standard large trauma craniotomy and routine craniotomy on severe traumatic brain injury. Methods： for analysis of brain in our hospital in February 2015 -2017 year in February from injury in 102 patients with severe clinical data, according to the different treatment options were divided into two groups, the conventional bone flap craniotomy in treatment of 51 patients as control group, the standard big bone flap decompression surgery in the treatment of 51 patients as the observation group, the effect was compared between two groups nerve function. Results： the observation group after surgery first, 2 intracranial pressure level （ 21.10 ＋ 2.40 ） mmHg, mmHg （ 19.06 ＋ 2.29 ） than the control group （ 30.12 -＋ 2.60） , mmHg （ 27.09 2.46 ） mmHg score low, 1 and 2 months after treatment of nerve function and （20.35 - 1.10 ）, （ 10.20 - 0.50 ） scores than the control group （ 30.40 - 2.20 ）, （ 18.35 ＋ 2.08 ） points lower, the difference was statistically significant （ P 〈 0.05 ） ; the total complication rate in the observation group than the control group 7.84% was 23.53% lower, the difference was statistically significant （ P 〈 0.05 ）. Conclusion： the treatment of severe craniocerebral injury with standard large decompressive craniectomy could reduce intraeranial pressure, improve neurological func- tion and reduce complications.

关 键 词：颅脑损伤 重症 标准大骨瓣减压手术 常规骨瓣开颅手术 神经功能 

分 类 号：R651.5[医药卫生—外科学]