标准大骨瓣手术治疗重型颅脑损伤临床分析

Clinic analysis of Standard large craniectomy for the treatment of severe brain injury

目的通过随机分组研究标准大骨瓣手术对重型颅脑损伤患者颅内压(ICP)及预后的影响情况。方法重型颅脑损伤患者96例,随机分为标准大骨瓣手术组(n=54)及常规手术组(n=30)。两组在病人临床表现、损伤程度、受伤后至手术时间、术后处理上等无显著差异。结果标准大骨瓣手术组同常规手术组比较,ICP降低有明显差异(P<0.01),标准大骨瓣手术组预后良好率优于常规手术组(P<0.05),死亡率低于常规手术组(P<0.05),有明显差异(P<0.05),但增加了重残及植物生存率。结论大骨瓣手术对重型颅脑损伤患者ICP有明显治疗作用,并预后良好,降低死亡率。

Objective To study the influence of Standard large craniectomy for the intracranial pressure（ICP）and the outcome of patients with severe brain injury by randomization. Methods 96 patients, randomly divided into 2 groups, the Standard large craniectomy group（n= 54） ; the control group （n= 30） , two groups have no significant deviations in clinical situations, degree of injury, postoperative treatments and the periods between they were injuried and to be operation. Results Compared with control group, ICP decreased significantly in the standard large craniectomy group （P 〈 0. 01）, outcome better （P 〈 0.05）. death rates were decrease significantly （P〈 0. 05）, but serve incomplete and vegetation survival rate were increased. Conclusions The standard large craniectomy have significant therapeutical effect on ICP and outcome better, decreasing death rat .