标准去骨瓣减压与常规去骨瓣减压治疗重型颅脑外伤的对比研究

目的 探讨标准大骨瓣开颅术在治疗重型颅脑损伤中的临床应用价值.方法 选择64例重型颅脑外伤患者,随机均分为观察组和对照组,各32例,对照组使用常规去骨瓣减压术,观察组使用标准去骨瓣减压治疗,比较两组患者术后颅内压变化情况,以及术后6个月随访的预后情况及并发症.结果 观察组术后1、3、7d颅内压均低于对照组同时间段颅内压水平(P＜0.05),观察组经过治疗后预后良好者为16例,对照组仅为7例,观察组预后良好者比率明显大于对照组(P＜0.05),对照组出现术后脑积水和迟发性血肿比率均高于对照组(P＜0.05).结论 标准去骨瓣减压术治疗重症颅脑外伤,相对于常规去骨瓣减压术而言,能更好的降低患者术后颅内压,且术后疗效相对较好,并发症少,是一种值得推广的手术治疗方法.

Comparative Study of Conventional Treatment of Standard Decompressive Craniectomy and Decompression Craniectomy Severe Traumatic Brain Injury

Objective To comparative study of conventional treatment of standard decompressive craniectomy and decompression craniectomy severe traumatic brain injury.Methods 64 cases of severe head trauma patients were randomly divided into two groups,the control group of 32 patients using conventional decompressive craniectomy,the observation group treated with standard decompressive craniectomy,two groups were compared intracranial pressure changes and after 6 months of follow-up prognosis and the complications 1,3,7d after.Results The observation group intracranial pressure with time intracranial pressure level were lower than the control group(P<0.05),16 patients of the observation group were good prognosis after treatment,the control group only 7 cases,good prognosis of the observation group were significantly higher than the control group(P<0.05),control group had hydrocephalus and delayed postoperative hematoma rates were higher than the control group(P<0.05).Conclusion Standard decompressive craniectomy for severe traumatic brain injury can better reduce intracranial pressure and has relatively good curative effect,fewer complications,so it is a surgical treatment to be promoted.