重型颅脑损伤改良大骨瓣减压术的疗效

目的探讨改良大骨瓣减压术治疗重型颅脑损伤患者的治疗疗效。方法回顾分析2012年10月~2014年12月治疗的75例重型颅脑损伤患者,其中男性48例,女性27例,年龄21~42岁;平均(32.15±7.22)岁。根据手术方式,分为观察组(给予改良大骨瓣减压术,n=37)和对照组(采用常规骨瓣开颅术,n=38),观察两组患者治疗效果、术后并发症发生情况以及术后格拉斯哥预后评分(GOS)。结果观察组治疗良好率为29.73%,明显高于对照组的10.53%,差异有统计学意义(P0.05);两组死亡、植物生存、重中残比较差异无统计学意义(P0.05);观察组和对照组治疗前GOS差异比较无统计学意义(P0.05);观察组治疗后GOS为(12.16±2.43)分,明显高于对照组的(9.03±1.86)分,差异有统计学意义(P0.05);观察组术后并发症发生率为21.62%,明显低于对照组的57.90%,差异有统计学意义(P0.05)。结论改良大骨瓣减压术治疗重型颅脑损伤有较好的治疗疗效,能改善患者预后,值得在临床推广。

Curative effect of standard large bone flap decompression on severe traumatic brain injury

Objective To investigate the curative effect of standard large bone flap decompression on se-vere traumatic brain injury .Methods From Oct.2012 to Dec.2014,75 patients with severe traumatic brain injury were treated in our hospital,including 48 males,27 females,with an average of (32.15 ±7.22) years (21 to 42 years).They were divided into the observation group (given the standard large bone flap decompression ,n=37) and the control group(given conventional bone flap craniotomy ,n=38) according to the surgical mode .The effect of treat-ment,postoperative complications and postoperative Glasgow prognosis scores (GOS) were observed.Results The good rate in the observation group was 29.73%,significantly higher than that of 10.53% in the control group and the difference was statistically significant(P<0.05);difference in the rate of deaths,plant survival,severe interme-diate disability between the two groups was not statistically significant (P>0.05).There was no significant differ-ence in preoperative GOS between the observation group and the control group (P>0.05);postoperative GOS score in the observation group was (12.16 ±2.43) points,significantly higher than that in the control group (1.86 ± 2.43)points,and the difference was statistically significant (P<0.05).The incidence of postoperative complica-tions was 21.62%in the observation group ,which was significantly lower than that in the control group ( 57.90%, P<0.05).Conclusion Standard large bone flap decompression for the treatment of severe traumatic brain injury has good curative effect .It can improve the prognosis of patients and it is worth applying in the clinical promotion .