改良大骨瓣开颅术治疗重症颅脑损伤的效果  

Effect of modified large bone flap craniotomy in severe craniocerebral injury

作　　者：谢成金 刘光普[1] 李劲松[1] 

机构地区：[1]广东省梅州市人民医院神经外二科,广东梅州514031

出　　处：《中国当代医药》2017年第31期49-51,共3页China Modern Medicine

摘　　要：目的探究改良大骨瓣开颅术用于重症颅脑损伤患者的临床疗效及安全性。方法选取2014年1月~2017年2月我院收治的88例重症颅脑损伤患者,采用随机数字表法分为观察组和对照组,每组各44例。对照组患者行常规骨瓣开颅手术治疗,观察组患者则行改良大骨瓣开颅术治疗,比较两组患者手术前后的颅内压变化情况,及术后的Barthel指数、格拉斯哥转归评分(GOS)情况、术后并发症情况。结果两组患者术前的颅内压比较差异无统计学意义(P>0.05),两组患者术后颅内压均显著降低(P<0.05),但观察组改善程度优于对照组,差异有统计学意义(P<0.05);观察组患者术后的Barthel指数及GOS评分均显著高于对照组,差异有统计学意义(P<0.05);观察组患者术后并发症发生率为6.8%(3/44),显著低于对照组的36.4%(16/44),差异有统计学意义(P<0.05)。结论改良大骨瓣开颅术治疗重症颅脑损伤能更好的降低患者的颅内压,减少并发症的发生,改善患者的预后,值得在临床上推广应用。Objective To investigate the clinical efficacy and safety of modified large bone flap craniotomy in severe craniocerebral injury.Methods 88 severe cranioeerebral injury patients from January 2014 to February 2017 in our hospital were selected.Patients were divided into observation group and control group according to number method,and each group was 44 cases.Patients in control group were given general bone flap craniotomy, and patients in observation group were used modified large bone flap craniotomy.The changes of intracranial pressure before and after the operation were compared between the two groups,and the postoperative.Barthel index,Glasgow outcome score （GOS） and postoperative complications were observed.Results There was no significant difference between the two groups in preoperative intracranial pressure （P〉0.05）.The postoperative intraeranial pressure of the two groups decreased signifieantly（P〈0.05）, but the improvement degree of the observation group was better than that of the control group（P〈0.05）.The incidence of postoperative complications in the observation group was 6.8%（3/44）,significantly lower than that in the control group [36.4%（16/44）],the difference was statistically significant （P〈0.05）.Conclusion The treatment of severe eraniocerebral injury with modified large bone flap craniotomy can reduce intracranial pressure,reduce complications and improve the prognosis of patients.h is worth popularizing and applying in clinic.

关 键 词：重症颅脑损伤 开颅手术 改良大骨瓣开颅术 预后 

分 类 号：R651[医药卫生—外科学]