改良标准大骨瓣减压术联合头部局部亚低温治疗重型颅脑损伤的疗效观察

目的探讨改良标准大骨瓣减压术(ISLTC)联合头部局部亚低温治疗重型颅脑损伤(ST-BI)的临床效果及格拉斯哥昏迷评分(GCS)的变化情况。方法选取STBI患者58例,并随机分为观察组与对照组,每组29例,观察组采用ISLTC联合头部局部亚低温治疗,对照组仅采用ISLTC治疗,观察并比较两组的临床效果、颅内压及预后。结果观察组的总有效率明显高于对照组,而植物状态病死率明显低于对照组,两组比较均差异有统计学意义(P<0.05);观察组的颅内压值显著低于对照组(P<0.01);观察组的死亡率低于对照组(P<0.05),观察组的恢复良好率显著高于对照组(P<0.05)。结论 ISLTC治疗STBI具有手术视野开阔、骨窗范围大、减压充分、预后良好及并发症少等优点,同时给予头部局部亚低温治疗,能有效地提高临床疗效,改善GCS评分,降低植物病死率,是一个治疗STBI的理想方法。

Observation of the curative effect on improved standard large trauma craniotomy combined with mild hypothermia for head local in treatment for severe traumatic brain injuries

Objective To discuss the clinical effect and the change of the Glasgow coma score on the improved standard large trauma craniotomy combined with mild hypothermia for head local in treatment for severe traumatic brain injuries.Methods 58 patients with STBI were chosen,and were stochastically divided into observation group and control group,each group for 29 cases,the observation group was treated by the improved standard large trauma craniotomy combined with mild hypothermia for head local,and the control group was only treated by the improved standard large trauma craniotomy.The clinical effect,intracranial pressure and the prognosis were observed and compared.Results The total effective rate of the observation group was better than the control group,there were different statistical significances between two groups(P<0.05).The intracranial pressure of the observation group was lower than the control group(P<0.01),and the death rate was lower than the control group(P<0.05),the renew rate of the observation group was higher than the control group(P<0.05).Conclusions The ISLTC treats the STBI,it has broaden one’s horizon,the bone window is large,reducing pressure is sufficient,the prognosis is better,and has less complication.At the same time,treating with the mild hypothermia for head local,it can improve the clinical effect a lot,ameliorate the GCS,make the plant case fatality rate reduced,it is an ideal method to treat the STBI.