标准外伤大骨瓣开颅术治疗额颞部重型颅脑损伤临床观察  

Effect of standard large trauma craniotomy on frontotemporal severe traumatic brain injury

作　　者：吴浩 WU Hao(Department of Neurosurgery,People’s Hospital of Boai County,Boai 454450,China)

机构地区：[1]博爱县人民医院神经外科

出　　处：《中国实用神经疾病杂志》2019年第10期1117-1124,共8页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探究标准外伤大骨瓣开颅术对额颞部重型颅脑损伤(STBI)患者效果、术后并发症发生率及生活质量的影响。方法选取博爱县人民医院2012-08-2016-08收治的STBI患者98例,依据建档顺序分组各49例。对照组实施常规骨瓣开颅术,观察组采取标准外伤大骨瓣开颅术,统计比较2组手术前后脑功能障碍评分(DRS)、神经功能评分(NIHSS)、颅内压水平,术后进行5个月随访,对比2组预后、并发症发生情况及术前、术后5个月生活质量评分(SF-36)。结果观察组术后DRS、NIHSS评分及颅内压水平均较对照组降低,差异有统计学意义(P<0.05);经随访,观察组恢复良好率40.82%(20/49)高于对照组20.41%(10/49),并发症发生率6.12%(3/49)低于对照组20.41%(10/49),差异有统计学意义(P<0.05);2组术后5个月SF 36评分均较术前提高,且观察组升高幅度大于对照组,差异有统计学意义(P<0.05)。结论对额颞部重型颅脑损伤患者采用标准外伤大骨瓣开颅术治疗效果显著,可明显改善患者颅内压,促进脑功能及神经功能恢复,改善预后,提升患者生活质量,且并发症少。Objective To explore the effect of standard large trauma craniotomy in treating frontotemporal severe traumatic brain injury(STBI),and its effect on the incidence of postoperative complications and quality of life. Methods 98 cases of STBI in our hospital from August 2012 to August 2016 were selected and grouped according to the order of files,49 cases in each group.The control group received conventional bone flap craniotomy,while the observation group received standard large trauma craniotomy.The scores of brain dysfunction (DRS),neurological function score (NIHSS) and intracranial pressure were compared between the two groups before and after operation.After 5 months of follow up,the prognosis,complications and quality of life score (SF 36) before and after operation of the two groups were compared. Results The scores of DRS,NIHSS and intracranial pressure in the observation group were lower than those in the control group,and the difference was statistically significant( P <0.05).After follow up,the recovery rate in the observation group 40.82%(20/49) was higher than that in the control group 20.41%(10/49),the incidence of complications 6.12%(3/49) was lower than that in the control group 20.41%(10/49),and the difference was significant( P <0.05).The SF 36 score of the two groups increased 5 months after operation,and the increase in the observation group was greater than that in the control group( P <0.05). Conclusion The efficacy of standard large trauma craniotomy in treating frontotemporal severe traumatic brain injury is significant.It can obviously improve the intracranial pressure,promote the recovery of brain function and neurological function,improve the prognosis,and improve the quality of life of patients.Besides,it has fewer complications.

关 键 词：重症颅脑损伤 标准外伤大骨瓣开颅术 并发症 生活质量 神经功能 脑功能障碍评分 

分 类 号：R651.15[医药卫生—外科学]