单侧标准外伤大骨瓣开颅减压术治疗对冲性重型双侧颅脑损伤的临床研究  

Clinical study of unilateral standard large trauma craniotomy in the treatment of hedging severe bilateral craniocerebral injury

作　　者：黄斌[1] 谭智灵[1] 王荣彦 罗忠平[1] 姜志远[1] 廖佐明 Huang Bin;Tan Zhiling;Wang Rongyan(Department of Neurosurgery,Affiliated Hospital of Xiangnan University,Hunan 423000,China)

机构地区：[1]湘南学院附属医院神经外科,郴州423000

出　　处：《立体定向和功能性神经外科杂志》2021年第2期100-104,共5页Chinese Journal of Stereotactic and Functional Neurosurgery

基　　金：郴州市科技发展计划(编号:zdyf201970)。

摘　　要：目的探究单侧标准外伤大骨瓣开颅减压术治疗对冲性重型双侧颅脑损伤的效果。方法回顾性分析2017年3月至2020年6月本院收治的75例对冲性重型双侧颅脑损伤患者临床资料,根据手术方案的不同分成2组,对照组:37例,采用常规双侧骨瓣开颅减压术治疗,研究组:38例,采用单侧标准外伤大骨瓣开颅减压术治疗。比较两组颅内压、神经功能评定结果、术后6个月预后评估结果、术后并发症发生情况。结果术前两组颅内压比较,差异无统计学意义(P>0.05),术后7 d两组颅内压均低于术前(P<0.05),且术后7 d研究组颅内压低于对照组(P<0.05)。术前两组美国国立卫生研究院卒中量表(NIHSS)得分比较,差异无统计学意义(P>0.05),术后3个月两组NIHSS得分均低于术前(P<0.05),且术后3个月研究组NIHSS得分低于对照组(P<0.05)。术后6个月,研究组死亡率、存活率分别是18.42%、81.58%,对照组死亡率、存活率分别是45.95%、54.05%,组间比较差异有统计学意义(P<0.05)。研究组术后并发症总发生率13.16%,对照组术后并发症总发生率35.14%,组间比较差异有统计学意义(P<0.05)。结论单侧标准外伤大骨瓣开颅减压术治疗对冲性重型双侧颅脑损伤效果肯定,能显著性降低颅内压,促进神经功能恢复,改善预后,减少并发症。Objective To explore the effect of unilateral standard large trauma craniotomy in the treatment of hedging severe bilateral craniocerebral injury.Methods A retrospective analysis of the clinical data of 75 patients with hedging severe bilateral craniocerebral injury admitted to our hospital from March 2017 to June 2020 was divided into 2 groups according to the different surgical plans.Control group:37 cases,treated with conventional bilateral craniotomy for decom-pressive craniectomy,study group:38 cases,treated with unilateral standard large trauma craniotomy.The intracranial pressure,neurological function evaluation,6-month prognosis and postop-erative complications were compared between the two groups.Results There was no significant difference in intracranial pressure between the two groups before operation(P>0.05),on the 7th day after operation,the intracranial pressure in both groups was lower than that before operation(P<0.05),the intracranial pressure in the study group was lower than that in the control group(P<0.05).There was no significant difference in National Institutes of Health Stroke Scale(NIHSS)scores between the two groups before operation(P>0.05),the NIHSS scores of the two groups were lower than those before operation 3 months after operation(P<0.05).and the.NIHSS score of the study group was lower than that of the control group at 3 months after operation(P<0.05).At 6 months after operation,the mortality and survival rate of the study group were 18.42% and 81.58%,respectively,while those of the control group were 45.95% and 54.05%,respectively,there was significant difference between the two groups(P<0.05).The total incidence of postoperative complications in the study group was 13.16%,while that in the control group was 35.14%,the difference between the two groups was statistically significant(P<0.05).Conclusion Unilateral standard large trauma craniotomy is effective in the treatment of hedging severe bilateral craniocerebral injury.It can significantly reduce intracranial pressure,promot

关 键 词：单侧标准外伤大骨瓣开颅减压术 对冲性重型双侧颅脑损伤 临床研究 

分 类 号：R651[医药卫生—外科学]