大骨瓣开颅手术治疗重型颅脑外伤的临床价值

目的研究大骨瓣开颅手术治疗重型颅脑外伤的临床效果与价值。方法120例重型颅脑外伤患者,采用随机分组法分为对照组和实验组,每组60例。对照组采用常规骨瓣开颅手术进行治疗,实验组采用大骨瓣开颅手术进行治疗。对比两组患者的治疗效果、术后颅内压、并发症发生率。结果实验组患者治疗总有效率95.0%明显高于对照组的81.7%,差异具有统计学意义(P<0.05)。实验组患者术后3、5 d的颅内压分别为(18.4±2.6)、(15.5±2.5)mm Hg(1 mm Hg=0.133 kPa),低于对照组的(24.4±4.1)、(21.3±3.9)mm Hg,差异具有统计学意义(P<0.05)。实验组并发症发生率为5.0%,低于对照组的18.3%,差异具有统计学意义(P<0.05)。结论针对重型颅脑外伤患者采用大骨瓣开颅手术能够有效提高患者治疗效果,降低术后颅内压及并发症发生率,改善患者预后,值得推广使用。

Clinical value of large bone flap craniotomy in the treatment of severe craniocerebral trauma

Objective To study the clinical effect and value of large bone flap craniotomy in the treatment of severe craniocerebral trauma.Methods A total of 120 patients with severe craniocerebral trauma were divided into control group and experimental group according to random grouping method,with 60 cases in each group.The control group was treated with conventional bone flap craniotomy,and the experimental group was treated with large bone flap craniotomy.The therapeutic effect,postoperative intracranial pressure and incidence of complications were compared between the two groups.Results The total effective rate of treatment 95.0%of the experimental group was obviously higher than 81.7%of the control group,and the difference was statistically significant(P<0.05).The intracranial pressure at 3 and 5 d after surgery of the experimental group were(18.4±2.6)and(15.5±2.5)mm Hg(1 mm Hg=0.133 kPa),which were lower than(24.4±4.1)and(21.3±3.9)mm Hg of the control group,and the difference was statistically significant(P<0.05).The incidence of complications of the experimental group was 5.0%,which was lower than 18.3%of the control group,and the difference was statistically significant(P<0.05).Conclusion Large bone flap craniotomy can effectively improve the treatment effect of patients with severe head trauma,reduce postoperative intracranial pressure and the incidence of complications,and improve the prognosis of patients.It is worthy of popularization and application.