重型闭合性颅脑损伤行双侧平衡去骨瓣减压术的疗效和安全性分析

目的对重型闭合性颅脑损伤行双侧平衡去骨瓣减压术的疗效和安全性进行探讨。方法选取2011年1月—2013年12月在该院治疗的80例重型闭合性颅脑损伤患者,随机分为两组,每组40例。对照组采用单侧标准外伤大骨瓣减压术进行治疗,观察组采用双侧平衡去骨瓣减压术进行治疗,对两组患者的疗效及安全性进行对比。结果治疗前,两组患者的颅内压差异无统计学意义（P〉0.05）;治疗1、3 d后,观察组患者的颅内压分别是（31.66±6.83）mm Hg、（27.41±4.84）mm Hg,对照组分别是（21.41±5.19）mm Hg、（19.35±3.52）mm Hg,差异有统计学意义（P〈0.05）。观察组并发症发生率为10%明显低于对照组的27.5%,差异有统计学意义（P〈0.05）。结论双侧平衡去骨瓣减压术治疗重型闭合性颅脑损伤疗效确切,有效降低了患者的术后并发症发生率,具有良好的安全性。

Analysis of the Efficacy and Safety of Bilateral Balance Decompressive Craniectomy in the Treatment of Severe Closed Head Injury

Objective To investigate the efficacy and safety of bilateral balance decompressive craniectomy in the treatment of severe closed head injury. Methods 80 cases of patients with severe closed head injury treated in our hospital from January 2011 to December 2013 were randomly divided into two groups, 40 cases in each group. The control group was treated with unilateral decompression standard large trauma craniectomy, the observation group was treated with bilateral balance decompressive craniecto-my. And the curative effect and safety were compared between the two groups. Results Before treatment, the difference in intracranial pressure between the two groups was not statistically significant（P〉0.05）; 1 d, 3 d after treatment, the intracranial pressure of the observation group was（31.66±6.83）mm Hg,（27.41±4.84） mm Hg, respectively, and that of the control group was（21.41±5.19） mm Hg,（19.35±3.52）mm Hg, respectively, the differences were statistically significant（P〈0.05）. The incidence of complications of the observation group was 10%, significantly lower than the control group＇s 27.5%, the difference was statistically significant（P〈0.05）. Conclusion Bilateral balance decompressive craniectomy in the treatment of severe closed head injury has a definite effect, which can reduce the incidence of postoperative complications effectively with good safety.