改良去骨瓣减压术与标准去骨瓣减压术治疗重度颅脑损伤的临床研究

目的比较改良去骨瓣减压术与标准去骨瓣减压术治疗重度颅脑损伤的临床效果,为临床优化治疗方案提供参考。方法将2008年10月~2011年10月在我院治疗的224例重度颅脑损伤患者随机分为观察组和对照组,每组各112例。观察组采用改良去骨瓣减压术治疗,对照组采用标准去骨瓣减压术治疗,比较两组患者手术时间、术中出血量、术后住院时间、手术并发症发生率、患者GCS评分等指标。结果观察组患者手术并发症发生率为33.04%,对照组为54.46%,两组比较差异有统计学意义（χ2=8.130,P〈0.05）。两组手术时间（t=11.720,P=0）,术中出血量（t=17.904,P=0）比较差异均有统计学意义,观察组患者GCS评分结果为（10.57±1.47）分,对照组为（8.59±3.20）分,组间比较差异具有统计学意义（t=6.659,P〈0.05）。观察组恢复良好患者与对照组比较,差异具有统计学意义（χ2=12.570,P〈0.05）。结论改良去骨瓣减压术治疗重度颅脑损伤可有效改善患者预后,缩短术后住院时间,降低治疗费用,值得临床进一步研究验证。

Clinical research of improved decompressive craniectomy and standard decompressive craniectomy in the treatment of severe craniocerebral injury

Objective To compare the clinical effects of improved decompressive craniectomy and standard decompressive craniectomy in the treatment of severe craniocerebral injury,to provide reference for optimizing clinical therapeutic regimen.Methods 224 patients with severe craniocerebral injury treated in our hospital from October 2008 to October 2011 were randomly divided into the observation group and the control group,with 112 patients in each group respectively.The observation group was treated with the improved decompressive craniectomy and the control group was treated with the standard decompressive craniectomy.The operative time,intraoperative blood loss,postoperative hospital stay,incidence of operative complications,patients’ GCS score and other indicators of the two groups were compared.Results The incidence rate of operative complications was 33.04% in the observation group and 54.46% in the control group,with statistically significant difference between the two groups(χ2 = 8.130,P < 0.05).The GCS score were(10.57±1.47) points in the observation group and(8.59±3.20) points in the control group,with statistically significant difference between the two groups(t = 6.659,P < 0.05).Conclusion The improved decompressive craniectomy in the treatment of severe craniocerebral injury can effectively improve the prognosis of patients,shorten hospital stay and reduce cost of treatment,thereby worthy of further clinical research and validation.