无骨桥双额开颅大骨瓣减压术对双额脑挫裂伤患者颅内压及预后的影响  

Effect of decompression of large bone flap with double frontal craniotomy without bone bridge on intracranial pressure and prognosis of patients with double frontal contusion

作　　者：叶世阳 YE Shiyang(Department of Neurosurgery,People's Hospital of Pingxiang City,Jiangxi Province,Pingxiang,Jiangxi,337000,China)

机构地区：[1]江西省萍乡市人民医院神经外科,江西萍乡337000

出　　处：《当代医学》2021年第33期38-40,共3页Contemporary Medicine

摘　　要：目的探讨无骨桥双额开颅大骨瓣减压术对双额脑挫裂伤患者颅内压及预后的影响。方法采用随机数字表法将2018年2月至2019年2月于本院就诊的双额脑挫裂伤患者60例分为两组,各30例。对照组采用双侧去大骨瓣减压术,观察组采用无骨桥双额开颅大骨瓣减压术,比较两组颅内压、昏迷程度及预后情况。结果术后3、7 d,观察组颅内压水平均低于对照组,差异有统计学意义(P<0.05);术后,两组Glasgow昏迷评分量表(GCS)评分均高于术前,且观察组高于对照组,差异有统计学意义(P<0.05);术后随访1年,观察组格拉斯哥预后量表(GOS)分级优于对照组,差异有统计学意义(P<0.05)。结论采用无骨桥双额开颅大骨瓣减压术治疗双额脑挫裂伤患者效果显著,可有效降低颅内压,改善昏迷程度,且预后良好。Objective To investigate the effect of decompression of large bone craniotomy without bone bridge on the intracranial pressure and prognosis of patients with double frontal contusion and laceration.Methods 60 patients with double frontal contusion and laceration in our hospital from February 2018 to February 2019 were selected and they were divided into two groups according to random table method,with 30 cases in each group.The control group underwent bilateral decompression with large craniectomy,and the observation group underwent decompression with double frontal craniotomy without bone bridge.The intracranial pressure,coma degree and prognosis between the two groups were compared.Results 3 d and 7 d after operation,the intracranial pressure in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).After the operation,the glasgow coma score scale(GCS)scores of the two groups were higher than those before the operation,and the observation group was higher than the control group,the difference was statistically significant(P<0.05);after 1 year follow-up,the glasgow outcome scale(GOS)grade of the observation group was better than the control group,the difference was statistically significant(P<0.05).Conclusion The treatment effect of double frontal contusion and laceration of patients with double frontal craniotomy without bone bridge is significant,which can effectively reduce intracranial pressure,improve the degree of coma,and have good prognosis.

关 键 词：双额脑挫裂伤 无骨桥双额开颅大骨瓣减压术 颅内压 预后 

分 类 号：R651.15[医药卫生—外科学]