标准外伤大骨瓣开颅术治疗重型颅脑损伤分析

目的 观察标准外伤大骨瓣开颅治疗重型颅脑损伤的临床疗效,探讨改善重型颅脑损伤患者预后的有效措施.方法 对我院2002-01～2006-12 86例重型颅脑损伤患者作为治疗组实施标准外伤大骨瓣开颅术,对照组选择1997-01～2001-12按常规额颞骨瓣开颅术治疗的124例重型颅脑损伤患者,治疗结果按GOS评分进行评定,并进行统计学分析比较.结果 治疗组总有效率56.98%,显著高于对照组的33.06%,其病死率为26.74%,显著低于对照组的45.97%(P＜0.05).结论 标准外伤大骨瓣开颅手术治疗重型颅脑损伤,术后减压充分,从而减轻继发性颅脑损伤,能有效改善其预后并降低病死率.

Clinical analysis of treating severe traumatic brain injury with standard large trauma craniotomy

Objective To observe the clinical effect of severe traumatic brain injury(sTBI) patients treated by standard large trauma craniotomy and discuss effective methods to improve the prognosis of sTBI. Methods We actualized standard large trauma craniotomy on sTBI patients from January 2002 to December 2006 and regarded them as therapeutic group.The patients with sTBI from January 1997 to December 2001 were treated by familiar craniotomy with fronto-temporal bone flap.The two groups were graded by GOS and the data were analyzed by statistical method.Results The overall effective rate of therapeutic group was 56.98% which was significantly higer than that of control group.And the mortality rate of therapeutic group was 26.74% which was significantly lower than that of control group. Conclusion It's effective to the patients with sTBI treated by standard large trauma craniotomy for reducing intracranial pressure and the secondary TBI.This method could effectively reform the prognosis and reduce the mortality rate of sTBI.