标准外伤大骨瓣开颅术治疗重型颅脑损伤的效果分析  

Analysis on Effect of Standard Large Trauma Craniotomy in Treatment of Severe Craniocerebral Injury

作　　者：张景帅 Zhang Jingshuai(Caoxian County Panshi Hospital,Heze 274400,Shandong Province,China)

机构地区：[1]山东省曹县磐石医院,山东菏泽274400

出　　处：《中国社区医师》2023年第27期11-13,共3页Chinese Community Doctors

摘　　要：目的:探讨标准外伤大骨瓣开颅术治疗重型颅脑损伤的效果。方法:选取2019年1月—2022年12月山东省曹县磐石医院收治的重型颅脑损伤患者150例作为研究对象,以随机数字表法分为两组,各75例。常规组实施常规骨瓣开颅术治疗,标准组实施标准外伤大骨瓣开颅手术治疗。比较两组临床疗效、并发症发生情况、预后情况、颅内压水平及神经功能。结果:标准组治疗总有效率高于常规组,差异有统计学意义(P=0.001)。标准组并发症发生率低于常规组,差异有统计学意义(P=0.004)。标准组恢复良好率高于常规组,死亡率、植物人状态发生率低于常规组,差异有统计学意义(P<0.05);两组中度、重度残疾率比较,差异无统计学意义(P>0.05)。术后3、5 d,标准组颅内压水平低于常规组,差异有统计学意义(P<0.05)。术后,标准组美国国立卫生研究院卒中量表评分低于常规组,差异有统计学意义(P=0.003)。结论:重型颅脑损伤患者实施标准外伤大骨瓣开颅术的效果显著,可降低并发症发生率,改善预后,降低颅内压水平,减轻手术对患者神经功能造成的损伤。Objective:To investigate the effect of standard large trauma craniotomy in treatment of severe craniocerebral injury.Methods:A totl of 150 patients with severe craniocerebral injury treated in Shandong Province Caoxian County Panshi Hospital from January 2019 to December 2022 were selected as the study subjects.They were divided into two groups according to random number table method,with 75 cases in each group.The conventional group was treated with conventional craniotomy,and the standard group was treated with standard large trauma craniotomy.The clinical efficacy,complications,prognosis,intracranial pressure level and nerve function of the two groups were compared.Results:The overall response rate of treatment in the standard group was higher than that in the conventional group,and the difference was statistically significant(P=0.001).The complication rate in the standard group was lower than that in the conventional group,and the difference was statistically significant(P=0.004).The good recovery rate in the standard group was higher than that in the conventional group,and the mortality and vegetative status incidence in the standard group were lower than those in the conventional group,and the difference was statistically significant(P<0.05).There was no significant difference in the rates of moderate and severe disability between the two groups(P>0.05).At 3 d and 5 d after surgery,the intracranial pressure level in the standard group was lower than that in the conventional group,and the difference was statistically significant(P<0.05).After surgery,the National Institute of Health Stroke Scale score in the standard group was lower than that in the conventional group,and the difference was statistically significant(P=0.003).Conclusion:The standard large trauma craniotomy in patients with severe craniocerebral injury is effective,and can reduce the incidence of complications,improve prognosis,reduce the level of intracranial pressure,and reduce the injury of nerve function of patients.

关 键 词：标准外伤大骨瓣开颅术 重型颅脑损伤 并发症 

分 类 号：R651.15[医药卫生—外科学]