标准大骨瓣减压术联合选择性脑局部亚低温对重型颅脑损伤的疗效分析

Standard large trauma craniotomy combined selective regional cerebral mild hypothermia on the effect of severe head injury

目的探讨对重型颅脑损伤患者采用标准大骨瓣减压术,同时配合头部局部亚低温疗法,观察治疗的效果及GCS评分变化情况。方法选择我院2007年1月～2010年1月收治的60例重型颅脑损伤患者作为研究对象,随机分为联合组及对照组各30例,联合组采用标准大骨瓣减压术,同时配合选择性脑局部亚低温疗法,对照组仅采用标准大骨瓣减压术,观察比较两组的疗效及GCS评分变化。结果联合组的总有效率明显高于对照组,差异有统计学意义,且联合组的植物状态病死率明显低于对照组(P<0.05)。两组治疗前GCS评分比较,差异无统计学意义,治疗后,两组GCS评分均明显提高,且联合组与对照组GCS评分比较,差异有统计学意义(P<0.05)。结论对重型颅脑损伤患者采用标准大骨瓣减压术,同时配合选择性脑局部亚低温疗法治疗能提高临床疗效,改善GCS评分,降低植物病死率,值得临床推广和应用。

Objective To investigate patients with severe head injury with standard large trauma craniotomy,in conjunction with the head mild hypothermia therapy,observe the effects of treatment and GCS score were observed.Methods In our hospital in January 2007 ～2010 1 were treated in 60 patients with severe traumatic brain injury patients as research subjects were randomly divided into combined group and control group 30 cases,the joint group of standard large trauma craniotomy at the same time selective brain hypothermia with local therapy,the control group using only standard large trauma craniotomy,observed cases were evaluated and the GCS score changes.Results The total effective combination group was significantly higher,with the difference statistically significant,and the combined group of plant mortality was significantly lower than the control group status（P0.05）.GCS scores between the two groups before treatment,no significant difference after treatment,both groups significantly increased GCS split,and the combination group compared with the control group,GCS score,by the difference statistically significant（P0.05）.Conclusion Patients with severe head injury with standard large trauma craniotomy,in conjunction with selective cerebral mild hypothermia can improve the clinical efficacy of treatment,improve GCS score,lower plant mortality,is worthy of promotion and application.