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控制性减压术对中老年重型颅脑损伤的治疗效果评价
引用本文:权瑜,巩守平,吕健,王举波,程格庆.控制性减压术对中老年重型颅脑损伤的治疗效果评价[J].华北国防医药,2016(2):66-69.
作者姓名:权瑜  巩守平  吕健  王举波  程格庆
作者单位:西安交通大学第二附属医院神经外科, 西安,710004
摘    要:目的:探讨控制性减压术对中老年重型颅脑损伤患者的疗效。方法选择西安交通大学第二附属医院2010年9月—2014年9月收治的100例中老年重型颅脑损伤患者,52例接受控制性减压术治疗(观察组),48例接受大骨瓣减压术治疗(对照组)。术后6个月评价比较两组格拉斯哥昏迷分级评分( GCS)、神经行为认知状态检查表评分( NCSE)、日常生活活动能力评分( Barthel指数)、颅内压(术中、手术结束及术后6个月)及预后,同时比较两组术中及术后并发症发生情况。结果观察组各项评价指标及预后均明显优于对照组(P<0.05,P<0.01),并发症总发生率明显低于对照组(P<0.05)。结论使用控制性减压术治疗中老年重型颅脑损伤,患者预后良好且并发症少。

关 键 词:重型颅脑损伤  控制性减压术  大骨瓣减压术  治疗效果

Effect Evaluation of Controlling Decompression in Treatment of Middle and Elderly Patients with Severe Cranio-cerebral Trauma
Abstract:Objective To investigate the effect of controlling decompression in treatment of middle and elderly patients with severe craniocerebral trauma. Methods A total of 100 middle and elderly patients with severe craniocere-bral trauma admitted during September 2010 and September 2014 were recruited in this study, and were divided into ob-servation group (n=52) undergoing controlling decompression and control group (n=48) undergoing big bone flap cra-niotomy decompression. The Glasgow coma scale ( GCS) score, neurobehavioral cognitive status examination ( NCSE) score, activities of daily living score ( Barthel index) , intracranial pressure values ( during the operation, at the end of operation and 6 months after the operation) and prognosis were evaluated and compared 6 months after operation in the two groups, and the incidence rates of complications during and at the end of the operation were also compared in the two groups. Results In the observation group, all the indexes and prognosis were superior to those in the control group (P<0. 05, P<0. 01), and the total incidence rate of complications was significantly lower than that in the control group (P<0. 05 ) . Conclusion The controlling decompression has good prognosis and less complications in treatment of middle and elderly patients with severe craniocerebral trauma.
Keywords:Severe craniocerebral trauma  Controlling decompression  Big bone flap craniotomy decompression  Treatment outcome
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