预见性双侧平衡去骨瓣减压治疗重型闭合性颅脑损伤疗效观察

目的：探讨预见性双侧平衡去骨瓣减压术治疗重型闭合性颅脑损伤的临床效果及安全性，促进患者康复。方法：选取符合标准的患者80例，采用随机数字表的方法分为观察组和对照组各40例，观察组采用预见性双侧平衡去骨瓣减压术，对照组采用单侧标准外伤大骨瓣减压手术，比较二者临床治疗效果。结果：治疗前两组患者颅内压相似（P＞0．05），治疗后患者颅内压较治疗前均降低，但是观察组下降幅度更大，差异均有统计学意义（P＜0．05）。观察组患者术中急性脑膨出发生率及术后切口疝发生率均明显低于对照组，差异有统计学意义（P＜0．05）。观察组患者生存质量明显优于对照组，差异有统计学意义（P＜0．05）。观察组患者术后并发症发生率明显低于对照组（P＜0．05）。结论：预见性双侧平衡去骨瓣减压术治疗重型闭合性颅脑损伤，可以有效降低死亡率，促进患者术后康复，提高生存质量，值得临床推广应用。

Observation on the Effects of Predictive Bilateral Balance Decompressive Craniectomy on Severe Closed Craniocerebral Injury

Objective：To investigate the clinical effects and safety of predictive bilateral balance de-compressive craniectomy in the treatment of severe closed craniocerebral injury and to promote the rehabilita-tion of the patients.Methods：80 patients meeting the criteria were selected and randomly divided into ob-servation group and control group, 40 patients in each group;the observation group was treated with predic-tive bilateral balance decompressive craniectomy , while the control group was treated with unilateral standard decompressive craniectomy, and the clinical therapeutic effects of the two groups were compared.Results：Before the treatments, the intracranial pressures of the patients of the two groups were similar （P〉0.05）;af-ter the treatments, the intracranial pressures of the patients of the two groups were both decreased when com-pared with those before the treatments, but the decreasing extent of the observation group was greater, and the differences were both statistically significant （ P〈0 .05 ） .The incidence of intraoperative acute cenen-cephalocele and the incidence of postoperative incisional hernia of the patients of the observation group were both lower than those of the control group, and the differences were statistically significant （P〈0.05）.The life quality of the observation group was significantly better than that of the control group , and the difference was statistically significant （ P〈0 .05 ） .And the incidence of postoperative complications of the patients of the observation group was significantly lower than that of the control group （P〈0.05）.Conclusion：Predic-tive bilateral balance decompressive craniectomy in the treatment of severe closed craniocerebral injury can effectively decrease mortality, promote postoperative rehabilitation and elevate the life quality of the patients,and consequently .It is worthy of clinical application .