探讨改良标准外伤大骨瓣开颅术治疗重型颅脑外伤的临床价值  

Exploring the Clinical Value of Mdified Standard Trauma Craniotomy with Large Bone Flap in the Treatment of Severe Craniocerebral Trauma

作　　者：钱中琪[1] 丁绪元[1] 杨少峰[1] 刘大军[1] QIAN Zhong-qi;DING Xu-yuan;YANG Shao-feng;LIU Da-jun(Department of Neurosurgery,Taizhou Second People's Hospital,Taizhou,Jiangsu Province,225500 China)

机构地区：[1]泰州市第二人民医院神经外科,江苏泰州225500

出　　处：《系统医学》2020年第19期76-77,80,共3页Systems Medicine

摘　　要：目的观察改良标准外伤大骨瓣开颅术(SLTC)治疗重型颅脑外伤(SCT)的临床疗效。方法选择2015年7月—2019年6月在该院接受手术治疗的66例SCT病例,根据手术方法不同分为对照组和研究组。对照组31例实施标准SLTC手术,研究组35例实施改良标准SLTC手术。对比两组的手术结局,术后1 d和5 d颅内压水平,比较两组术后并发症情况。结果研究组患者GOS良好率71.43%高于对照组的45.16%,差异有统计学意义(Z=4.692,P<0.05)。研究组术后1、5 d颅内压水平分别为(24.10±2.45)mmHg、(11.25±1.34)mmHg均明显低于对照组的(28.46±2.58)mmHg、(14.03±1.41)mmHg,差异有统计学意义(t=7.038、8.208,P<0.05)。研究组术后并发症发生率8.57%低于对照组的29.03%,差异有统计学意义(χ2=4.626,P<0.05)。结论重型颅脑外伤的情况紧急,可采取改良标准外伤大骨瓣开颅术治疗,有效降低颅内压水平,减少多种术后并发症,改善预后。Objective To observe the clinical effect of modified standard large trauma craniotomy(SLTC)in the treatment of severe head trauma(SCT).Methods Sixty-six SCT cases who underwent surgical treatment in the hospital from July 2015 to June 2019 were selected and divided into control group and study group according to different surgical methods.31 patients in the control group underwent standard SLTC surgery,and 35 patients in the study group underwent modified standard SLTC surgery.The surgical outcomes of the two groups were compared,the intracranial pressure levels 1 and 5 d after the operation,and the postoperative complications of the two groups were compared.Results The good rate of GOS in the study group was 71.43%higher than that in the control group,which was 45.16%.The difference was statistically significant(Z=4.692,P<0.05).The intracranial pressure levels of the study group were(24.10±2.45)mmHg and(11.25±1.34)mmHg respectively on the 1st and 5th day after operation,which were significantly lower than those of the control group(28.46±2.58)mmHg and(14.03±1.41)mmHg.The data of the two groups'difference was statistically significant(t=7.038,8.208,P<0.05).The postoperative complication rate of the study group was 8.57%lower than that of the control group 29.03%,and the data difference was statistically significant(χ2=4.626,P<0.05).Conclusion The situation of severe traumatic brain injury is urgent,and modified standard large bone flap craniotomy can be used to effectively reduce the level of intracranial pressure,reduce various postoperative complications and improve the prognosis.

关 键 词：改良标准外伤大骨瓣开颅术 重型颅脑外伤 颅内压水平 并发症 

分 类 号：R651.15[医药卫生—外科学]