双侧去骨瓣减压术及单侧标准外伤大骨瓣手术治疗颅脑损伤的效果比较  

Comparison of the effects of bilateral decompressive craniectomy and unilateral standard large trauma craniectomy in the treatment of craniocerebral injury

作　　者：李杰[1] 杨瀚君 李昌[3] 耿怀振[4] LI Jie;YANG Hanjun;LI Chang;GENG Huaizhen(Neurosurgery Department,Shandong Shan County Central Hospital/Huxi Hospital Affiliated to Jining Medical College,Heze 274300;Emergency Surgery,Shandong Shan County Central Hospital/Huxi Hospital Affiliated to Jining Medical College,Heze 274300;Hepatobiliary Surgery Department,Shandong Shan County Central Hospital/Huxi Hospital Affiliated to Jining Medical College,Heze 274300;Urology Department,Heze Municipal Hospital,Heze 274031,China)

机构地区：[1]山东单县中心医院/济宁医学院附属湖西医院神经外科,山东菏泽274300 [2]山东单县中心医院/济宁医学院附属湖西医院急诊外科,山东菏泽274300 [3]山东单县中心医院/济宁医学院附属湖西医院肝胆外科,山东菏泽274300 [4]菏泽市立医院泌尿外科,山东菏泽274031

出　　处：《临床医学研究与实践》2021年第24期69-71,共3页Clinical Research and Practice

摘　　要：目的比较双侧去骨瓣减压术及单侧标准外伤大骨瓣手术治疗颅脑损伤的临床效果。方法回顾性分析2018年5月至2020年5月我院收治的112颅脑损伤患者的临床资料,按照手术方式的不同将其分为双侧组(n=60,双侧去骨瓣减压术)与单侧组(n=52,单侧标准外伤大骨瓣手术)。比较两组患者的头部CT环池形态、颅内压、NSE、S100β水平、术后并发症发生情况及预后。结果治疗7 d后,两组的头部CT环池形态、颅内压均改善,且双侧组优于单侧组(P<0.05)。治疗7 d后,两组的NSE及S100β水平均降低,且双侧组低于单侧组(P<0.05)。双侧组的术后并发症总发生率低于单侧组,预后良好率高于单侧组(P<0.05)。结论与单侧标准外伤大骨瓣手术比较,双侧去骨瓣减压术治疗颅脑损伤能够明显降低颅内压及术后并发症发生率,整体预后较好。Objective To compare the clinical effects of bilateral decompressive craniectomy and unilateral standard large trauma craniectomy in the treatment of craniocerebral injury.Methods The clinical data of 112 patients with craniocerebral injury admitted in our hospital from May 2018 to May 2020 were retrospectively analyzed.According to different surgical methods,the patients were divided into bilateral group(n=60,bilateral decompressive craniectomy)and unilateral group(n=52,unilateral standard large trauma craniectomy).The CT ring cistern shape of head,intracranial pressure,NSE and S100β levels,postoperative complications and prognosis were compared between the two groups.Results After 7 d of treatment,the CT ring cistern shape of head and intracranial pressure in both groups improved,and those in the bilateral group were better than the unilateral group(P<0.05).After 7 d of treatment,the levels of NSE and S100βin both groups decreased,and those in the bilateral group were lower than the unilateral group(P<0.05).The total incidence of postoperative complications in the bilateral group was lower than that in the unilateral group,and the rate of good prognosis was higher than that in the unilateral group(P<0.05).Conclusion Compared with unilateral standard large trauma craniectomy,bilateral decompressive craniectomy in the treatment of craniocerebral injury can significantly reduce the intracranial pressure and the incidence of postoperative complications,and the overall prognosis is good.

关 键 词：双侧去骨瓣减压术 单侧标准外伤大骨瓣手术 颅脑损伤 

分 类 号：R651[医药卫生—外科学]