大骨瓣减压并小脑幕切开在重型颅脑损伤术中的效果  

Effect of Large Bone Flap Decompression Combined with Cerebelli Tentorium Incision in Severe Craniocerebral Injury

作　　者：谷卫民 GU Weimin(People's Hospital of Juancheng County,Juancheng 274600,China)

机构地区：[1]鄄城县人民医院,山东鄄城274600

出　　处：《中外医学研究》2021年第22期146-148,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:观察重型颅脑损伤患者应用大骨瓣减压并小脑幕切迹切开术的临床治疗效果。方法:选取笔者所在医院76例重型颅脑损伤患者,根据入院码随机分成观察组和对照组,每组38例。观察组患者手术采用额颞顶大骨瓣减压并小脑幕切迹切开术,对照组患者采用传统标准额颞顶开颅大骨瓣减压术,观察术后两组患者的治疗效果。结果:观察组恢复良好率为47.4%、中度残疾率18.4%、重度残疾率7.9%、植物生存率10.5%、死亡率15.8%,对照组分别为26.3%、23.7%、15.8%、13.2%、21.1%,观察组远期治疗效果优于对照组(P<0.05)。观察组术后鞍上池、环池、四叠体池显现率分别为60.5%、71.0%、57.9%,明显高于对照组的36.8%、44.7%、39.4%(P<0.05)。结论:选择早期给予大骨瓣减压并小脑幕切迹切开术,能够有效缓解、改善患者术后颅内压增高临床症状,提高患者的生存质量及生存率。Objective:To observe the clinical effect of large bone flap decompression combined with tentorial incision in patients with severe craniocerebral injury.Method:A total of 76 patients with severe craniocerebral injury were randomly divided into observation group and control group,with 38 cases in each group.Patients in observation group were treated with decompression of large bone flap decompression combined with tentorial incision,while patients in control group were treated with standard horseshoe incision craniotomy,and the therapeutic effects of the two groups were observed.Result:The good recovery rate,moderate disability rate,severe disability rate,plant survival rate and mortality rate of the observation group were 47.4%,18.4%,7.9%,10.5% and 15.8%,respectively,while those of the control group were 26.3%,23.7%,15.8%,13.2% and 21.1%,respectively.The long-term treatment effect of the observation group was better than that of the control group (P<0.05).The postoperative appearance rates of suprasellar cistern,ambient cistern and quadriceps cistern in the observation group were 60.5%,71.0% and 57.9% respectively,which were significantly higher than 36.8%,44.7% and 39.4% in the control group (P<0.05).Conclusion:Early large bone flap decompression combined with tentorial incision can effectively improve the clinical symptoms and survival rate of patients with severe craniocerebral injury,which has high clinical value.

关 键 词：大骨瓣减压 重型颅脑损伤 小脑幕切开术 

分 类 号：R651.15[医药卫生—外科学]