大骨瓣减压治疗重型颅脑损伤的临床疗效分析  

Analysis of Clinical Efficacy of Large Bone Flap Decompression in the Treatment of Severe Craniocerebral Injury

作　　者：翟雨 沈斌 陶俊 ZHAI Yu;SHEN Bin;TAO Jun(Department of Neurosurgery,People's Hospital of Liuhe District,Nanjing,Jiangsu Province,211500 China)

机构地区：[1]南京市六合区人民医院神经外科,江苏南京211500

出　　处：《系统医学》2021年第14期84-86,共3页Systems Medicine

摘　　要：目的探讨对重型颅脑损伤患者采取标准大骨瓣开颅术进行治疗的临床效果。方法选取六合区人民医院脑外科在2018年6月—2020年6月期间收治的72例重型颅脑损伤患者,以数字随机法将其分为研究组(n=36)和对照组(n=36),对照组以常规的骨瓣开颅减压术进行治疗,研究组应用标准大骨瓣开颅术,比较两组治疗效果、颅内压降低情况及患者预后情况等。结果治疗后颅内压均得到明显降低,研究组第1天(24.31±1.98)mmHg、第3天(18.20±1.45)mmHg及第7天(14.21±1.65)mmHg降低幅度更加优于对照组,差异有统计学意义(t=9.852、16.856、15.232,P<0.05);治疗后研究组GCS评分(11.59±1.66)分、NIHSS评分(20.28±2.35)分优于对照组,差异有统计学意义(t=4.624、15.092,P<0.05);研究组术后并发症发生率11.11%显著低于对照组,差异有统计学意义(χ^(2)=5.143,P<0.05)。结论对重型颅脑损伤患者采取标准大骨瓣开颅术进行治疗,效果肯定,改善患者颅内压,减轻神经功能缺损程度,减少并发症,最终改善患者预后,值得推广。Objective To investigate the clinical effect of standard large craniotomy for patients with severe head injury.Methods A total of 72 patients with severe craniocerebral injury who were admitted to the department of neurosurgery of Luhe District People’s Hospital from June 2018 to June 2020 were selected and divided into a study group(n=36)and a control group(n=36)by the numerical randomization method.The control group was treated with conventional craniotomy with craniotomy and the study group was treated with standard large craniotomy with large craniotomy to compare the treatment effects,reduction of intracranial pressure and patient prognosis between the two groups.Results After treatment,the intracranial pressure was significantly reduced.The reduction on the first day(24.31±1.98)mmHg,the third day(18.20±1.45)mmHg and the seventh day(14.21±1.65)mmHg of the study group was better than that of the control group,the difference was statistically significant(t=9.852,16.856,15.232,P<0.05);after treatment,the GCS score(11.59±1.66)points and NIHSS score(20.28±2.35)points of the study group were better than those of the control group,the difference was statistically significant(t=4.624,15.092,P<0.05);the postoperative complication rate of the study group was 11.11%significantly lower than the control group,the difference was statistically significant(χ^(2)=5.143,P<0.05).Conclusion The standard large bone flap craniotomy for patients with severe head injury has a positive effect.It can improve the intracranial pressure of the patient,reduce the degree of neurological deficit,reduce complications,and ultimately improve the prognosis of the patient.It is worthy of promotion.

关 键 词：重型 颅脑损伤 标准大骨瓣开颅术 颅内压 神经功能缺损 预后 

分 类 号：R651[医药卫生—外科学]