重型闭合性颅脑损伤患者行双侧平衡去骨瓣减压治疗效果分析  

Analysis of the Effect of Bilateral Balanced Decompressive Craniectomy for Patients with Severe Closed Craniocerebral Injury

作　　者：唐波 TANG Bo(Department of Neurosurgery,Chenggong Hospital Affiliated to Xiamen University(The 73rd Group Army Hospital),Xiamen,Fujian Province,361000 China)

机构地区：[1]厦门大学附属成功医院(陆军第七十三集团军医院)神经外科,福建厦门361000

出　　处：《中外医疗》2020年第6期64-66,69,共4页China & Foreign Medical Treatment

摘　　要：目的分析双侧平衡去骨瓣减压在重型闭合性颅脑损伤患者中的应用效果。方法方便选取该院2010年1月-2019年1月收治的100例重型闭合性颅脑损伤患者纳入该次研究,依照数字随机表法将其分为对照组(50例)与观察组(50例),对照组给予单侧去骨瓣减压术治疗,观察组则行双侧平衡去骨瓣减压术治疗,术后比较两组患者治疗前后颅内压变化情况,统计预后情况,观察生活质量。结果术后3 d,对照组患者的颅内压指数(28.16±4.23)mmHg高于观察组(16.43±3.25)mmHg,对比差异有统计学意义(t=15.549,P<0.05)。术后6个月对照组患者各项生活质量评分(64.58±3.32)分、(65.37±4.21)分、(62.54±3.34)分、(68.12±7.58)分低于观察组(76.58±2.65)分、(78.56±3.21)分、(73.27±4.86)分、(75.79±5.64)分,对比差异有统计学意义(t=19.975、17.617、12.974、5.740,P<0.05)。对照组患者的残疾率32.00%和死亡率12.00%均明显高于观察组22.00%、2.00%,对比差异有统计学意义(χ~2=0.082、7.681,P<0.05)。结论在重型闭合性颅脑损伤接受治疗时,采用双侧平衡去骨瓣减压疗法的临床效果较好,值得在临床治疗中推广。Objective To investigate and analyze the effect of bilateral balanced osteotomy in patients with severe closed brain injury. Methods Convenient select 100 patients with severe closed craniocerebral injury admitted to the hospital from January 2010 to January 2019 were included in this study. They were divided into control group(50 cases) and observation group(50 cases) according to the method of digital random table. The control group was treated with unilateral decompressive craniectomy, while the observation group was treated with bilateral balanced decompressive craniectomy. The intracranial pressure of the two groups before and after treatment was compared. The quality of life and prognosis were observed. Results A3 day, the intracranial pressure index(28.16±4.23) mmHg of the control group was higher than that of the observation group(16.43±3.25) mmHg, and the difference was statistically significant(t=7.590, 15.549, P<0.05). Six months affter surgery the quality of life scores of the control group(64.58±3.32)points,(65.37±4.21)points,(62.54±3.34)points, and(68.12±7.58)points were lower than the observation group(76.58±2.65)points,(78.56±3.21)points,(73.27±4.86)points,(75.79 ±5.64) points, the difference was statistically significant(t =19.975, 17.617, 12.974, 5.740, P <0.05). The disability rate of the control group was 32.00% and the mortality rate was 12.00%, which was significantly higher than that of the observation group(22.00%, 2.00%). The difference was statistically significant(χ~2=0.082, 7.681, P<0.05). Conclusion In the treatment of severe closed craniocerebral injury, the clinical effect of bilateral balanced decompressive craniectomy is better, which is worth popularizing in clinical treatment.

关 键 词：重型闭合性颅脑损伤 单侧去骨瓣减压疗法 双侧平衡去骨瓣减压疗法 生存效率 

分 类 号：R651[医药卫生—外科学]