标准大骨瓣减压术治疗重型颅脑损伤35例临床研究

目的探讨标准大骨瓣减压术治疗重型颅脑损伤的手术效果及预后、并发症情况。方法选取我院2010年1月～2013年1月收治的35例重型颅脑损伤患者，均行标准大骨瓣减压术治疗，设立为观察组，选择同期收治的35例重型颅脑损伤患者32例，行常规骨瓣开颅术治疗，比较两组患者术后的预后情况及并发症。结果根据格拉斯哥积分（glasgow outcome scale，G0S）评分法评定预后疗效：观察组患者的预后恢复良好率达65.71%（23/35），对照组患者的预后恢复良好率达46.88%（15/32），观察组患者的预后明显优于对照组，差异具有统计学意义（P〈 0.05）。观察组患者术后发生脑积水、脑组织膨出或坠出、皮下或硬膜下积液、外伤性脑梗死、局部切口疝、远隔部位血肿、切口感染及脑脊液漏并发症的例数均少于对照组，差异具有统计学意义（P〈 0.05）。结论标准大骨瓣减压术治疗重型颅脑损伤手术效果确切，可以明显改善患者的预后，降低并发症的发生，值得推广和应用。

Standard decompressive craniectomy treatment clinical study of 35 casesof severe traumatic brain injury

Objective To investigate the effect of surgery for the treatment of severe traumatic brain injury and prognosis ,complications of standard large trauma decompression. Methods A total of 35 patients with severe traumaticbrain injury patients admitted in our hospital from January 2010 to January 2013 underwent standard hemicraniectomytreatment,the establishment of the observation group, the same period treated 35 patients with severe traumatic braininjury 32 patients underwent conventional craniotomy treatment, prognosis and complications of the two groups werecompared after. Results According to the Glasgow Points （Glasgow outcome scale, GOS） score assessed the prognosticeffect ： the observation group of patients with good prognosis recovery rate of 65.71% （23/35）, the control group prognosis of patients with a good recovery rate of 46.88% （15/32）, the prognosis of patients of the observation group wasbetter than the control group,the difference was statistically significant （P 〈 0.05）.Number of cases of the observationgroup developed postoperative hydrocephalus,brain tissue swelling or falling out, subcutaneous or subdural effusion,traumatic cerebral infarction, local incisional hernia, distant parts of the hematoma, wound infection and cerebrospinalfluid leakage complications less than that of the control group, the difference was statistically significant （P〈 0.05）. Conclusion The standard large trauma decompression surgery exact treatment of severe traumatic brain injury can signifi-cantly improve patient outcomes and reduce the incidence of complications,it is worth the promotion and application.