大骨瓣减压术中渐进减压治疗重型颅脑外伤对患者GCS评分和预后的影响分析  

Analysis of the Effect of Progressive Decompression on GCS Score and Prognosis of Patients with Severe Craniocerebral Trauma During Large Craniotomy

作　　者：刘虹灵 LIU Hong-ling(Department of Neurosurgery,Second Affiliated Hospital of Shenyang Medical College,Shenyang 110001,China)

机构地区：[1]沈阳医学院附属第二医院神经外科,辽宁沈阳110001

出　　处：《中国医药指南》2020年第21期107-108,共2页Guide of China Medicine

摘　　要：目的探讨对重型颅脑外伤患者选择大骨瓣减压术中渐进减压方法治疗后对GCS评分以及预后效果产生的影响。方法选择我院2017年7月至2019年2月收治的93例重型颅脑外伤患者作为实验对象;数字奇偶法分组后探究每组手术疗法;比照组(46例):选择常规大骨瓣减压术完成疾病治疗;实验组(47例):选择大骨瓣减压术中渐进减压方法完成疾病治疗;比较两组患者GCS评分、颅内压水平、术后并发症发生率以及预后良好率。结果手术前,实验组重型颅脑外伤患者GCS评分以及颅内压水平同比照组比较差异不明显(P>0.05);手术后,实验组重型颅脑外伤患者GCS评分高于比照组明显,颅内压水平低于比照组明显(P<0.05);实验组重型颅脑外伤患者术后并发症发生率(8.51%)低于(36.96%)比照组明显(P<0.05);实验组重型颅脑外伤患者预后良好率(48.94%)高于比照组(13.04%)明显(P<0.05)。结论重型颅脑外伤于临床接受大骨瓣减压术中渐进减压治疗,于患者GCS评分的提升,颅内压水平降低,术后安全性以及预后良好率的提升,均获得确切作用效果,最终对于重型颅脑外伤患者康复状态的提升,奠定基础。Objective To investigate the effect of progressive decompression with large craniotomy on GCS score and prognosis in patients with severe craniocerebral trauma. Methods 93 patients with severe craniocerebral trauma admitted to our hospital from July 2017 to February 2019 were selected as experimental subjects. The digital parity method was used to explore the surgical treatment in each group. Comparison group(46 cases) : conventional large bone flap decompression was selected to complete the disease treatment;In the experimental group(47 cases), progressive decompression in large bone flap decompression was selected to complete the disease treatment. GCS score, intracranial pressure, postoperative complication rate and favorable prognosis were compared between the two groups. Results Before surgery, there was no significant difference in GCS score and intracranial pressure between the experimental group and the comparison group(P>0.05). After the operation, the GCS score of patients with severe craniocerebral trauma in the experimental group was significantly higher than that in the comparison group, and the intracranial pressure level was significantly lower than that in the comparison group(P<0.05). The incidence of postoperative complications in patients with severe craniocerebral trauma in the experimental group(8.51%) was lower than that in the comparison group(36.96%)(P<0.05). The prognosis rate of severe craniocerebral trauma patients in the experimental group(48.94%) was significantly higher than that in the comparison group(13.04%)(P<0.05). Conclusion Progressive decompression therapy during craniocranial decompression for severe craniocerebral trauma in clinical practice, as well as improvement of GCS score, reduction of intracranial pressure, postoperative safety and good prognosis rate, all obtained definite effects, and finally laid a foundation for improvement of rehabilitation status of severe craniocerebral trauma patients.

关 键 词：大骨瓣减压术中渐进减压 重型颅脑外伤 GCS评分 预后 并发症 

分 类 号：R651.15[医药卫生—外科学]