不同去骨瓣减压术式治疗重型颅脑损伤对比研究  

Comparative study on curative effect of different decompressive craniectomy in patients with severe craniocerebral injury and its influence on prognosis

作　　者：孙晓峰[1] 刘惠祥[1] 高嵘[1] 蒋锋[1] 倪海波[1] 钱晓波[1] 李建[1] 季东凯 

机构地区：[1]张家港市第一人民医院神经外科,江苏张家港215600

出　　处：《中国实用神经疾病杂志》2018年第2期157-160,共4页Chinese Journal of Practical Nervous Diseases

基　　金：苏州市科技发展计划-产业技术创新专项(民生科技-医疗卫生应用基础研究)项目(编号:SYSD2017002)

摘　　要：目的分析不同去骨瓣减压术式治疗重型颅脑损伤的临床效果及对预后的影响。方法选取2011-01—2016-01张家港市第一人民医院治疗的重型颅脑损伤患者72例。根据手术方法分为观察组(n=37)与对照组(n=35)。2组均给予常规的术前治疗,观察组采取标准大骨瓣减压术,对照组采取常规去骨瓣减压术。观察2组治疗效果,术后颅内压、并发症发生情况及术后6个月GOS评分。结果观察组良好率64.86%,对照组为40.00%。观察组良好率明显高于对照组,差异有统计学意义(P<0.05)。观察组术后颅内压明显低于对照组,差异有统计学意义(P<0.05)。2组并发症发生率差异无统计学意义(P>0.05)。观察组术后6个月GOS评分(4.34±0.44)分,对照组为(3.89±0.43)分。观察组GOS评分明显高于对照组(t=6.18,P<0.05)。结论标准大骨瓣减压术治疗重型颅脑损伤的临床效果显著,术后颅内压下降快,值得推广。Objective To analyze and explore the clinical effect of different decompressive craniectomy in the treatment of severe traumatic brain injury. Methods Seventy-two cases of severe craniocerebral injury treated in our hospital from 2011 to 2016 months were divided into observation group （n = 37） and control group （n = 35） according to different operation methods. Two groups of patients were given routine preoperative treatment, the observation group was treated with standard large bone flap de compression,and the control group was treated with conventional decompressive craniectomy. The therapeutic effects of the two groups were observed. The intracranial pressure, complications and GOS score after operation were observed in the two groups. Resuits The good outcome rate of observation group was 64.86%, while the control group was 40%. The observation group was significantly better than the control group,the difference was statistically significant （P〈0.05）. The intracranial pressure in the observation group was significantly lower than that in the control group （P〈0.05）. There was no significant difference in the ad- verse rate between the two groups （P〉0.05）. The GOS score of the observation group was 6 months （4.34±0.44） ,and the con trol group was （3.89 ±0.43）. The GOS score of the observation group was significantly higher than that of the control group （t 6.18,P〈0. 05）. Conclusion jury is significant. The clinical effect of standard large trauma craniotomy in the treatment of severe traumatic brain in

关 键 词：标准大骨瓣减压术 常规去骨瓣减压术 颅脑损伤 GOS评分 并发症 

分 类 号：R651.15[医药卫生—外科学]