改良标准大骨瓣开颅术治疗重型颅脑外伤32例临床疗效分析

Study on application of modified standard large trauma craniotomy on treating severe traumatic head injury

目的分析改良标准外伤大骨瓣开颅术治疗重型颅脑外伤的临床疗效，探讨其临床适用性。方法选择2010年3月。2013年3月于我院就诊的62例重型颅脑外伤患者，分为实验组32例和对照组30例，对照组患者采用标准外伤大骨瓣开颅术，而实验组采用改良标准外伤大骨瓣开颅术治疗重型颅脑外伤。观察两组患者呼吸、心电图、意识、颅内压等指标情况以及预后情况。结果实验组患者呼吸、心电图、意识、颅内压等指标改善情况明显优于对照组，差异有统计学意义（P〈0．05）。实验组患者远期存活率为84．38％，明显高于对照组患者的存活率60．00％，差异有统计学意义（χ2=4．62，P〈0．05）。结论改良标准外伤大骨瓣开颅术对于患者的基本生命体征影响较小，明显降低死亡率，适合临床长期推广应用。

Objective To study the operative techniques and practical value of modified standard large trauma craniotomy in the treatment of severe traumatic head injury. Methods 62 patients with severe traumatic brain injury patients from March 2010 to March 2013 in our hospital were randomly divided into experimental group of 32 patients and control group of 30 patients,the control group were treated with standard large trauma craniotomy. The experimental group used improved standard large trauma craniotomy for treating severe traumatic brain injury. Observed two groups of patients with respiratory,ECG,consciousness,intracranial pressure and other indicators as well as prognosis. Results The experimental group patients with respiratory,ECG,consciousness,intracranial pressure indicators improved significantly better than the control group,the difference was statistically significant （P 〈 0.05）. The experimental group patients long-term survival rate was 84.38%,significantly higher than the control in the patient＇s survival rate of 60.00%,the difference was statistically significant（χ2= 4.62,P 〈 0.05）. Conclusion Modified standard large trauma craniotomy is an effective methods for severe traumatic head injury because of its advantages such as sufficient exposure,convenient operation and thorough decompression and increased survival rate and lowered complications incidence.