标准大骨瓣与常规骨瓣减压术治疗重型颅脑损伤患者的效果及术后情况  

To study the effect of standard large bone flap and conventional bone decompression on severe craniocerebral injury and its effect on postoperative quality of life and neurological function recovery

作　　者：王方发[1] 雍成明[1] 杨代明[1] 宣家龙[1] 徐兵[1] 李海平 Wang Fangfa;Yong Chengming;Yang Daiming;Xuan Jialong;Xu Bin;Li Haiping(Department of Neurosurgery,the Affiliated Chaohu Hospital of Anhui Medical University,Hefei 238000,China)

机构地区：[1]安徽医科大学附属巢湖医院神经外科,巢湖238000

出　　处：《中国临床保健杂志》2019年第3期420-422,共3页Chinese Journal of Clinical Healthcare

摘　　要：目的探讨标准大骨瓣与常规骨瓣减压术对重型颅脑损伤患者的疗效及对患者术后生活质量、神经功能恢复的影响。方法选取70例重型颅脑损伤患者,按照随机数字表法均分为两组。观察组35例患者给予标准大骨瓣开颅术。对照组35例患者采取常规骨瓣开颅术。采用格拉斯哥预后评分(GOS)统计两组患者康复情况,采用36条简明健康状况问卷评分调查两组患者生活质量,观察患者的疗效、颅内压以及神经功能恢复情况。结果观察组35例患者格拉斯哥预后评分明显优于对照组,差异有统计学意义(P <0. 05)。观察组患者36条简明健康状况问卷评分明显优于对照组,差异有统计学意义(P <0. 05)。观察组患者术后颅内压改善情况明显优于对照组,差异有统计学意义(P <0. 05)。术后观察组患者术后第3天、第7天血清皮质醇水平明显低于对照组,差异有统计学意义(P <0. 05)。结论标准大骨瓣减压术可通过充分减压降低神经功能损伤程度,可改善患者的格拉斯哥预后评分,有利于改善患者术后生活质量。Objective To investigate the effect of standard large bone flap and conventional bone decompression on severe craniocerebral injury and its effect on postoperative quality of life and neurological function recovery.Methods 70 patients with severe head injury admitted were divided into two groups according to the random number table method.A total of 35 patients in the observation group were given standard large bone flap craniotomy.In the control group,35 patients underwent conventional craniotomy.The Glasgow Outcome Scale (GOS) was used to count the rehabilitation status of the two groups of patients.36 concise health status questionnaires were used to investigate the quality of life of the two groups,and the efficacy,intracranial pressure,and neurological recovery of the patients were observed.Results The Glasgow Outcome Score in 35 patients in the observation group was significantly better than that in the control group.The difference was statistically significant (P<0.05).The scores of the 36 concise health questionnaires in the observation group were significantly better than those in the control group,and the difference was statistically significant (P<0.05).The improvement of postoperative intracranial pressure in the observation group was significantly better than that in the control group,and the difference was statistically significant (P<0.05).The levels of serum cortisol in the postoperative observation group were significantly lower than those in the control group on the third and seventh day after operation (P<0.05).Conclusion Standard large cranial flap decompression can reduce the degree of neurological impairment through adequate decompression,which can improve the patient's Glasgow Outcome Score and improve the postoperative quality of life.

关 键 词：颅脑损伤 减压颅骨切除术 神经康复 预后 

分 类 号：R651.15[医药卫生—外科学]