双额大骨瓣减压术治疗脑外伤后难治性弥漫性脑肿胀患者的临床效果  

Clinical Study of Double Large Bone Flap Decompression for Refractory Diffuse Brain Swelling after Traumatic Brain Injury

作　　者：王大维 WANG Dawei(Department of Nneurosurgery,Shenyang Red Cross Hospital,Shenyang 110013,China)

机构地区：[1]沈阳市红十字会医院神经外科,辽宁沈阳110013

出　　处：《中国医药指南》2022年第5期88-90,共3页Guide of China Medicine

摘　　要：目的分析脑外伤后难治性弥漫性脑肿胀患者行双额大骨瓣减压术治疗的效果。方法选取在医院就诊的100例脑外伤后难治性弥漫性脑肿胀患者为研究对象,按照治疗方式的不同进行分组,对照组50例,采用保守治疗,观察组50例,采用双额大骨瓣减压术治疗,对两组患者的颅内压、格拉斯哥昏迷量表(GCS)评分以及并发症发生率进行比较。结果治疗前,两组患者颅内压及GCS评分比较,差异无统计学意义(P>0.05),与治疗前比较,治疗后两组患者颅内压及GCS评分均显著好转(P<0.05),与对照组比较,观察组颅内压更低,GCS评分更高(P<0.05);两组预后良好率比较,观察组明显高于对照组(P<0.05)。较对照组,观察组脑积水、硬膜下积液以及感染等并发症发生率更低(P<0.05)。结论予以脑外伤后难治性弥漫性脑肿胀患者双额大骨瓣减压术治疗的效果理想,有利于改善患者预后,促进患者颅内压下降,减少术后并发症。Objective To analyze the effect of double-frontal large bone flap decompression in patients with refractory diffuse brain swelling after brain trauma.Methods A total of 100 patients with intractable diffuse brain swelling after brain injury who were treated in our hospital were selected as the research objects.They were divided into groups according to the different treatment methods.The control group 50 cases were treated with conservative treatment;the observation group 50 cases were treated with double for the treatment of large forehead craniectomy,the intracranial pressure,Glasgow coma score(GCS score)and the incidence of complications were compared between the two groups.Results Before treatment,the intracranial pressure and GCS scores of the two groups were similar(P>0.05).Compared with before treatment,the intracranial pressure and GCS scores of the two groups were significantly improved after treatment(P<0.05).Compared with the control between groups,the observation group had lower intracranial pressure and higher GCS score(P<0.05);the good prognosis rate of the two groups was compared with the control group(P<0.05).Compared with the control group,the observation group had a lower incidence of complications such as hydrocephalus,subdural effusion and infection(P<0.05).Conclusion Decompression of double frontal bone flaps in patients with refractory diffuse brain swelling after brain trauma,the surgical treatment effect is ideal,which is beneficial to improve the patient's prognosis,promote the decrease of intracranial pressure,and reduce postoperative complications.

关 键 词：脑外伤 难治性弥漫性脑肿胀 双额大骨瓣减压术 颅内压 并发症 

分 类 号：R615[医药卫生—外科学]