双侧标准外伤大骨瓣开颅去骨瓣减压术治疗双侧额颞部重型颅脑损伤患者的疗效及安全性分析  

Efficacy and Safety Analysis of Bilateral Standard Trauma Craniotomy with Craniotomy and Decompressive Craniotomy in the Treatment of Patients with Bilateral Frontotemporal Severe Head Injury

作　　者：郭贵杰 GUO Guijie(Liaocheng Xinxian People's Hospital,Liaocheng,Shandong Province,252400 China)

机构地区：[1]聊城市莘县人民医院,山东聊城252400

出　　处：《系统医学》2021年第18期62-64,共3页Systems Medicine

摘　　要：目的探究对双侧额颞部重型颅脑损伤患者施行双侧标准外伤大骨瓣开颅去骨瓣减压术治疗的效果。方法随机将2018年1月—2019年6月该院68例双侧额颞部重型颅脑损伤患者分为对照组(34例,施行双额冠状骨瓣开颅去骨瓣减压术治疗)、观察组(34例,施行双侧标准外伤大骨瓣开颅去骨瓣减压术治疗)。对比两组治疗有效率、格拉斯哥昏迷指数量表(glasgow coma scale,GCS)评分、颅内压、神经缺损功能评分及并发症发生率。结果观察组术后3、7、10 dGCS评分为(7.26±1.89)分、(9.92±1.82)分、(12.20±2.36)分较对照组更高,差异有统计学意义(t=2.350、5.542、6.100,P<0.05);观察组术后3、7、10 d神经功能缺损评分为(18.26±1.63)分、(15.92±1.54)分、(12.24±1.40)分较对照组更低,差异有统计学意义(t=11.846、6.617、10.678,P<0.05);观察组总有效率(73.53%)较对照组(50.00%)更高,并发症发生率(8.82%)较对照组(29.41%)低,差异有统计学意义(χ^(2)=3.985、4.660,P<0.05)。结论对双侧额颞部重型颅脑损伤患者施行双侧标准外伤大骨瓣开颅去骨瓣减压术的效果更佳,能有效降低颅内压,减轻昏迷程度,更有助于促进缺损神经功能恢复,并发症更少。Objective To explore the effect of decompressive craniotomy with standard large bone flap craniotomy on bilateral frontotemporal severe head injury.Methods From January 2018 to June 2019,68 patients with bilateral frontal and temporal severe head injury in the hospital were randomly divided into the control group(34 patients underwent double frontal coronary craniotomy and decompressive craniectomy),the observation group(34 cases,underwent bilateral standard trauma craniotomy and decompressive craniectomy).The treatment efficiency,glasgow coma scale(GCS)score,intracranial pressure,nerve defect score and complication rate were compared between the two groups.Results The GCS scores(7.26±1.89)points,(9.92±1.82)points,(12.20±2.36)points of the observation group were higher than those of the control group at 3 d,7 d,and 10 d after operation,the difference were statistically significant(t=2.350,5.542,6.100,P<0.05);observation group of scores of neurological deficits(18.26±1.63)points,(15.92±1.54)points,(12.24±1.40)points in the group 3 d,7 d,and 10 d after operation were lower than those of the control group,the difference were statistically significant(t=11.846,6.617,10.678,P<0.05).The total effective rate(73.53%)of the observation group was higher than that of the control group(50.00%),and the complication rate(8.82%)was lower than that of the control group(29.41%),the difference were statistically significant(χ^(2)=3.985,4.660,P<0.05).Conclusion For patients with bilateral frontotemporal severe head injury,the effect of decompressive craniotomy with standard large bone flap craniotomy is better.It can effectively reduce intracranial pressure,reduce the degree of coma,and promote the defect nerve function,with fewer complications.

关 键 词：额颞部 重型颅脑损伤 标准外伤大骨瓣开颅去骨瓣减压术 

分 类 号：R61[医药卫生—外科学]