标准大骨瓣与常规骨瓣减压术治疗重型颅脑损伤的对照研究  

Comparative Study of Standard Large Flap and Conventional Flap Decompression in the Treatment of Severe Craniocerebral Injury

作　　者：李庆[1] 李卫东[1] 丁源[1] 何庆璋[1] 陶保平[1] LI Qing;LI Weidong;DING Yuan(Wuhu First People's Hospital, Anhui wuhu 241000, China)

机构地区：[1]安徽省芜湖市第一人民医院神经外科

出　　处：《河北医学》2020年第2期311-314,共4页Hebei Medicine

基　　金：安徽省科技攻关项目，(编号:20179PE-9)

摘　　要：目的:观察标准大骨瓣与常规骨瓣减压术对重型颅脑损伤患者的治疗效果。方法:将90例重型颅脑损伤患者按照随机数字表简单随机分组法分为观察组和对照组,每组各45例。观察组采用标准大骨瓣减压并硬脑膜网状切开术治疗,对照组采用常规骨瓣减压并硬脑膜放射状切开术治疗。比较两组患者治疗后的颅内压(ICP)、脑代谢指标、意识障碍情况、疾病的预后及术后日常生活能力。结果:观察组患者的颅内压(ICP)、脑灌注压(CCP)、静脉血氧饱和度(SVO2)、格拉斯哥评分(GCS)、格拉斯哥预后评分(GOS)及日常生活能力指数(Bathel)均优于对照组,差异有统计学意义(P<0.05)。结论:与常规骨瓣减压并硬脑膜切开术相比较,标准大骨瓣减压并硬脑膜切开术治疗重型颅脑损伤,可有效降低颅内压、促进脑代谢,改善疾病的预后。Objective:To observe the therapeutic effect of standard large bone flap and conventional bone flap decompression on patients with severe craniocerebral injury.Methods:90 patients with severe craniocerebral injury were divided into observation group and control group according to random number table method,45 cases in each group.The observation group was treated with standard large bone flap decompression combined with dural reticulotomy,while the control group was treated with conventional bone flap decompression combined with radial dural incision.Intracranial pressure(ICP),brain metabolic index,disturbance of consciousness,prognosis of disease and ability of daily living after treatment were compared between the two groups.Results:The ICP,CCP,SVO2,GCS,GOS and Bathel of the patients in the observation group were better than those in the control group(P<0.05).Conclusion:Compared with conventional craniotomy and craniotomy,standard large craniotomy combined with duratomy can effectively reduce intracranial pressure,promote brain metabolism and improve the prognosis of severe craniocerebral injury.

关 键 词：重型颅脑损伤 标准大骨瓣减压并硬脑膜切开术 常规骨瓣减压并硬脑膜切开术 

分 类 号：R651.15[医药卫生—外科学]