标准大骨瓣减压术治疗重型颅脑损伤的临床效果研究  

Clinical Effect of Standard Decompressive Craniectomy in the Treatment of Severe Craniocerebral Injury

作　　者：吴德模[1] 管义祥[1] 刘中平[1] 丁锦荣[1] 蔡舒[1] 李军[1] Wu Demo;Guan Yixiang;Liu Zhongping;Ding Jinrong;Cai Shu;Li Jun(Department of Neurosurgery,Hai'an People's Hospital,Nantong University,Jiangsu Nantong 226600)

机构地区：[1]南通大学附属海安市人民医院,江苏海安226600

出　　处：《辽宁医学杂志》2020年第5期43-46,共4页Medical Journal of Liaoning

摘　　要：目的分析标准大骨瓣减压术治疗重型颅脑损伤的临床效果。方法经医院伦理学会批准随机选取我院外科2015年1月-2019年6月收治的重型颅脑损伤患者60例,采用双盲法将其分成对照组(常规骨膜减压术治疗)与治疗组(标准大骨瓣减压术治疗),每组30例。比较两组患者颅内压水平、临床疗效、记忆功能及并发症。结果术前两组患者颅内压水平差异比较无统计学意义(P>0.05)。术后(加上颅内压水平)降低,其中治疗组患者术后1d、5d颅内压水平低于对照组(P<0.05)。两组患者临床疗效差异比较有统计学意义(P<0.05)。治疗组患者长时记忆、短时记忆、瞬时记忆、记忆商评分高于对照组(P<0.05)。治疗组患者并发症发生率低于对照组(P<0.05)。结论标准大骨瓣减压术在解除重型颅脑损伤患者颅内压、保护神经功能、减少并发症、提高疗效方面有明显价值,建议使用。Objective To investigate the effect of standard decompressive craniectomy in the treatment of severe craniocerebral injury.Methods 60 patients with severe craniocerebral injury admitted to our hospital from January 2015 to June 2019 were randomly enrolled with the approval of the Hospital Ethics Society,and divided into two groups by double-blind method,each with 30 cases.The control group received routine decompression,while the treatment group received standard decompressive craniectomy.Intracranial pressure level,clinical efficacy,memory function and complications were compared between the two groups.Results There was no significant difference in intracranial pressure between the two groups before surgery(P>0.05).The Intracranial pressure was decreased after surgery.The intracranial pressure in the treatment group was lower than that in the control group at the post-operative 1 d and 5 d(P<0.05).The clinical efficacy showed statistic difference between groups(P<0.05).The scores of long-term memory,short-term memory,instantaneous memory and memory quotient in the treatment group were higher than those in the control group(P<0.05).The incidence of complications in the treatment group was lower than that in the control group(P<0.05).Conclusion Standard decompressive craniectomy can relieve the intracranial pressure,protect nerve function and reduce complications in patients with severe craniocerebral injury.

关 键 词：标准大骨瓣减压术 重型颅脑损伤 颅内压 记忆功能 并发症 

分 类 号：R651.15[医药卫生—外科学]