标准大骨瓣减压术与常规去骨瓣减压术治疗重型颅脑损伤疗效对比研究

目的对比研究标准大骨瓣减压术与常规去骨瓣减压术治疗重型颅脑损伤的手术效果。方法纳入研究的56例手术治疗的重型颅脑损伤患者，按照随机数字表法随机分为标准组和常规组两组，每组各28例。常规组采用常规去骨瓣减压术，观察组采用标准大骨瓣减压术。应用X2检验、t检验及方差分析对比分析两组的预后、并发症、CCS评分、术后不同时间点颅内压监测情况、术后随访ADL分级等。结果标准组术后死亡率低，预后良好，术后GCS评分降低较对照组明显，且术后颅内压降低较对照组明显，标准组术后的并发症明显少于对照组，随访12个月，标准组存活患者ADL分级Ⅰ级所占比率明显高于对照组，差异有统计学意义（P〈0．05）。结论与常规去骨瓣减压术比较，标准大骨瓣减压术治疗重型颅脑损伤预后好、并发症少、降低颅内压明显、患者存活率高，值得广泛推广和应用。

A comparative study of the effcacy of standard large hemicraniectomy with conventional decompressive craniectomy in treatment of severe traumatic brain injury

Objective To compare the standard large craniectomy and conventional decompressive craniectomy in treatment of severe traumatic brain injury outcome.Methods The study included 56 cases surgical treatment severe head injury patients,according to a random number table they were randomly divided into the standard group and the conventional group two,n = 28 cases.Conventional group with routine decompressive craniectomy in the observation group using standard large hemicraniectomy.Application of the χ2 test,t test and ANOVA analysis comparing two groups of prognosis,complications,CCS score,at different time points after intracranial pressure monitoring,postoperative follow-up ADL classification and so on.Results The standard postoperative mortality is low,the prognosis is good,after the GCS score was significantly lower than the control group,and the intracranial pressure was significantly lower than the control group,standard postoperative complications was significantly lower than the control group were followed up for 12 months,the standard group survival in patients with ADL grade class I was significantly higher than the percentage,the difference was statistically significant(P < 0.05).Conclusion Compared with conventional decompressive craniectomy compared to standard large decompressive craniectomy in treatment of severe traumatic brain injury prognosis is good,fewer complications,significantly lower intracranial pressure,the patient survival rate is high,should be widely promoted and applied.