两种手术治疗重型颅脑外伤的应用价值比较

目的探讨大骨瓣减压术与常规开颅手术治疗重型颅脑外伤的临床效果比较。方法选取黄冈市中心医院68例重型颅脑外伤患者,研究组34例行大骨瓣减压术,对照组34例行常规开颅手术,治疗结束6个月后对两组患者的疗效及并发症情况进行评价。结果研究组患者总治疗有效率为82.35%,明显高于对照组的64.71%,差异有统计学意义（P〈0.05）;研究组在急性脑膨出、迟发性血肿、切口脑脊液漏及癫痫发生率为11.76%,明显低于对照组的32.35%,差异有统计学意义（P〈0.05）。结论大骨瓣减压术治疗重型颅脑外伤较常规开颅手术疗效安全可靠,值得临床推广应用。

Comparison of clinical effects of two surgeries for the treatment of severe traumatic brain injury

Objective To investigate the clinical effects of large decompressive craniectomy and conventional craniotomy for the treatment of severe traumatic brain injury.Methods A total of 68cases with severe traumatic brain injury in this hospital were enrolled,and 34cases were divided into study group,given large decompressive craniectomy,and 34cases were divided into control group,given conventional craniotomy.The efficacy and complications of the two groups were evaluated six months after the treatment.Results The total effective rate of study group was 82.35%,significantly higher than the 64.71% of control group（P〈0.05）.The incidence rate of acute brain swelling,delayed hematoma,wound leakage of cerebrospinal fluid and epilepsy in study group was 11.76%,significantly lower than the 32.35%in control group（P〈0.05）.Conclusion Large decompressive craniectomy might be more safe and reliable than conventional craniotomy for the treatment of severe traumatic brain injury,and the former could be worthy of clinical application.