改良去大骨瓣减压术对重型颅脑损伤患者高级脑功能的影响

目的 探讨改良去大骨瓣减压术对重型颅脑损伤患者高级脑功能的影响.方法 选取84例重型颅脑损伤患者为研究对象,随机分为A、B组,每组42例,分别予以改良去大骨瓣减压术和标准外伤大骨瓣减压术治疗.比对两组患者术后格拉斯哥预后(GOS)分级情况差异,记录其治疗前后平衡功能评定量表(Fugl-Meyer)、洛文斯顿作业疗法用认知评定成套测验(LOTCA)评分结果,分析术后并发症发生率差异.结果 ①A组治疗无效率为19.0％,显著低于B组的45.2％(x2=6.604,P=0.010).②两组患者治疗后Fugl-Meyer及LOTCA评分均较治疗前显著提高,且A组评估结果优于B组(P＜0.05).③A组术后并发症发生率为20.5％,显著低于B组的47.2％(x2=6.010,P=0.014).结论 改良去大骨瓣减压术可有效改善重型颅脑损伤患者高级脑功能,具有并发症发生率低、预后良好等优势.

Effect of modified large craniectomy decompression on advanced brain function in patients with severe craniocerebral injury

Objective To investigate the effect of modified large craniectomy decompression on advanced brain function in patients with severe craniocerebral injury.Methods 84 cases of severe craniocerebral injury were selected as the study object and randomly divided into group A and group B,42 cases in each group.The two groups were respectively treated with modified large craniectomy decompression and standard trauma large craniotomy decompression.The difference in Glasgow outcome score (GOS) grading between two groups after surgery was compared.The scores of balance function rating scale (Fugl-Meyer) and Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) were recorded before and after treatment.The difference in the incidence of postoperative complications was analyzed.Results ① The ineffective rate in group A was significantly lower than that in group B (19.0％ vs.45.2％;x2=6.604,P=0.010).② After treatment,the scores of Fugl-Meyer and LOTCA in two groups were significantly higher than those before treatment,and the scores in group A were better than those in group B (P＜0.05).① The incidence of postoperative complications in group A was significantly lower than that in group B (20.5％ vs.47.2％;x 2=6.010,P=0.014).Conclusion Modified large craniectomy decompression can effectively improve advanced brain function in patients with severe craniocerebral injury,with a low incidence of complications and good prognosis.