浅析标准大骨瓣开颅减压术在颅脑损伤治疗中的临床效果

Clinical Effect Analysis of Standard Large Bone Flap Craniotomy and Decompression in Treatment of Craniocerebral Injury

目的对标准大骨瓣开颅减压术应用于颅脑损伤临床治疗中的效果进行分析。方法选取2010年1月-2019年3月收治的90例颅脑损伤患者,将其随机设对照组与治疗组,每组各45例,对照组予以常规的骨瓣开颅减压术治疗,治疗组予以标准大骨瓣开颅减压术治疗,观察两组疗效、并发症和神经功能缺损情况。结果治疗后1个月,治疗组治愈率高于对照组(P<0.05),中重度残疾率、植物生存状态及死亡率两组比较区别无统计学意义(P>0.05);治疗组并发症的总发生率是15.56%,对照组并发症的总发生率是40.00%,两组比较区别有统计学意义(P<0.05)。术前治疗组与对照组的神经功能缺损评分分别是(43.56±3.95)分、(43.77±4.16)分;术后3个月治疗组与对照组的神经功能缺损评分分别是(12.39±4.01)分、(21.06±4.22)分,两组比较区别有统计学意义(P<0.05)。术前两组颅内压水平相比区别不明显,术后1d、3d、7d两组颅内压均比术前有所降低,但治疗组降低效果明显比对照组更优,两组比较区别有统计学意义(P<0.05)。结论对颅脑损伤患者采用标准大骨瓣开颅减压术进行治疗疗效确切,预后效果好,优势较多,值得继续探讨。

Objective To analyze effect of standard large bone flap craniotomy decompression in clinical treatment of craniocerebral injury.Methods The paper chose 90 patients with craniocerebral injury treated from January 2010 to March 2019,and divided them into control group and treatment group randomly.Control group was treated with routine craniotomy and decompression,and treatment group with standard large craniotomy.Curative effect,complications and neurological deficits was observed between two groups.Results one month after treatment,cure rate in treatment group was higher than control group(P<0.05).There was no significant difference in moderate and severe disability rate,plant survival state and mortality between two groups(P>0.05);total incidence of complications was 15.56%in treatment group and 40.00%in control group,there was significant difference between two groups(P<0.05).Neurological deficit scores of treatment group and control group were(43.56±3.95)and(43.77±4.16)respectively;3 months after operation,neurological deficit scores of treatment group and control group were(12.39±4.01)and(21.06±4.22)respectively,there was significant difference between two groups(P<0.05),no significant difference in level of intracranial pressure between two groups before operation.Intracranial pressure of two groups decreased at 1D,3D and 7d after operation,reduction effect of treatment group was significantly better than control group,difference was statistically significant between two groups(P<0.05).Conclusion Standard large bone flap craniotomy decompression can achieve definite curative effect,good prognosis and many advantages for patients with craniocerebral injury,which is worthy of further discussion.