控制性减压术与标准大骨瓣减压术治疗老年重型颅脑损伤并发脑梗死的效果比较  

Effect comparison of controlled decompression and standard large decompressive craniectomy in the treatment of senile severe craniocerebral injury complicated with cerebral infarction

作　　者：许歆 陈小萍 

机构地区：[1]江西省萍乡市第二人民医院神经外科,江西萍乡337000

出　　处：《中国当代医药》2017年第31期61-64,共4页China Modern Medicine

摘　　要：目的探讨控制性减压术与标准大骨瓣减压术治疗老年重型颅脑损伤并发脑梗死的效果比较情况。方法分析我院2010年1月~2016年10月收治的72例患者临床资料,依据手术方式不同分为控制性减压术组36例和标准大骨瓣减压术组36例。观察两组患者术前、术中、术毕及术后6个月的颅内压情况,观察两组患者术后6个月神经行为状况测试(NCSE)评分、Barthel指数和格拉斯哥预后评分(GOS)评分情况,观察两组患者预后良好率情况。结果两组患者术前颅内压差异无统计学意义(P>0.05),控制性减压术组术中、术毕及术后6个月的颅内压均低于标准大骨瓣减压术组,控制性减压术组术后6个月NCSE评分、Barthel指数和GOS评分均高于标准大骨瓣减压术组,控制性减压术组患者预后良好率高于标准大骨瓣减压术组,差异均有统计学意义(P<0.05)。结论控制性减压术治疗老年重型颅脑损伤并发脑梗死患者,术后颅内压改善效果明显,预后良好,值得临床推广应用。Objective To explore the effect comparison of controlled decompression and standard large decompressive craniectomy in the treatment of severe craniocerebral injury complicated with cerebral infarction in the elderly.Methods The clinical data of 72 patients treated in our hospital from January 2010 to October 2016 were analyzed.According to the different surgical methods, they were evenly divided into controlled decompression group and standard large decompressive craniectomy group,36 eases in each group.The conditions of intracranial pressure before,during,just after, and 6-month after surgeries were observed in the two groups.The NCSE score,Barthel index and GOS score of the two groups were observed 6 months after operation.The favorable rate for prognosis in the two groups was also observed. Results Before surgery,there was no significant difference in the intraeranial pressure between the two groups.During, just after,and 6-month after operation,the intracranial pressure of the two groups was lower than that in the standard large decompressive craniectomy.In the controlled decompression,the NCSE score,Barthel index,and GOS score were all higher than those in the standard large decompressive craniectomy group 6 months after operation.The favorable rate for prognosis in the controlled decompression group was better than in the that of standard large decompressive craniecto- my group,with a statistical difference （P〈0.05）.Conclusion Controlled decompression is effective in the treatment of severe craniocerebral injury complicated with cerebral infarction in the elderly with remarkable improvement of intracranial pressure and favorable rate for prognosis,which is worthy of clinical application and promotion.

关 键 词：控制性减压术 标准大骨瓣减压术 老年重型颅脑损伤 脑梗死 比较 

分 类 号：R651.1[医药卫生—外科学]