单、双侧去骨瓣减压术治疗重型对冲性脑损伤患者的对比研究  

Acomparative Study of Single and Bilateral Debridement and Decompression For Severe Hedging Brain Injury

作　　者：张书娟 ZHANG Shu-juan(Department of Intensive Medicine,First People's Hospital,Shangqiu City,Shangqiu 476000 China)

机构地区：[1]商丘市第一人民医院重症医学科,河南商丘476000

出　　处：《内蒙古医学杂志》2020年第9期1035-1037,共3页Inner Mongolia Medical Journal

摘　　要：目的比较单侧标准外伤大骨瓣减压术、双侧去骨瓣减压术在重型对冲性脑损伤患者中的应用效果。方法回顾性选取2018年1月至2019年10月我院77例重型对冲性脑损伤患者,予以单侧标准外伤大骨瓣减压术治疗的38例为单侧组,予以双侧去骨瓣减压术治疗的39例为双侧组,比较两组术前术后颅内压,术后3个月预后情况,相关并发症(脑膨出、创伤性癫痫、颅内感染、脑脊液漏)发生情况。结果术后双侧组颅内压水平低于单侧组(P<0.05);术后3个月双侧组预后优于单侧组(P<0.05);双侧组并发症发生率7.69%低于单侧组26.32%(P<0.05)。结论与单侧标准外伤大骨瓣减压术治疗重型对冲性脑损伤相比,双侧去骨瓣减压术可显著降低颅内压水平,减少并发症发生,改善患者预后。Objective To compare the effect of unilateral standard trauma large bone flap decompression and bilateral bone flap decompression in patients with severe hedging brain injury.Methods From january^2018 to october 2019,77 patients with severe hedged brain injury in our hospital were retrospectively selected.38 patients treated with unilateral standard trauma large bone flap decompression were treated as unilateral group.39 patients treated with bilateral bone flap decompression were treated as bilateral group.the preoperative and postoperative intracranial pressure,3 months postoperative prognosis,and related complications(encephalocele,traumatic epilepsy,intracranial infection,cerebrospinal fluid leakage)were compared.Results After operation,the level of intracranial pressure in bilateral group was lower than that in unilateral group(P<0.05);the prognosis of bilateral group was better than that in unilateral group(P<0.05);the incidence of complications in bilateral group was 7.69%lower than that in unilateral group(26.32%)(0.05).Conclusion Compared with unilateral standard trauma large bone flap decompression for severe hedged brain injury,bilateral bone flap decompression can significantly reduce the level of intracranial pressure,reduce the occurrence of complications.

关 键 词：双侧去骨瓣减压术 重型对冲性脑损伤 单侧标准外伤大骨瓣减压术 预后 

分 类 号：R651.1[医药卫生—外科学]