60 例重症颅脑外伤患者开颅手术的临床分析

Clinical analysis of craniotomy in 60 patients with severe craniocerebral trauma

目的分析开颅手术治疗重症颅脑外伤患者的临床效果。方法选取2009年4月～2012年10月来本院接受治疗的60例重型颅脑外伤患者作为研究对象，实施大骨瓣开颅手术进行治疗，观察并比较手术前后患者格拉斯哥昏迷评分（GCS），同时对手术临床疗效及并发症发生情况进行评价。结果治疗前患者GCS为（5．42±1．44）分，治疗后为（12．57±3．75）分，治疗前后GCS差异有统计学意义（P〈0．05）；术后患者存活率达90．0％（54／60）；手术后患者发生脑积水7例，脑脊液外漏4例，脑膨出3例，其他并发症1例。结论大骨瓣开颅手术治疗重症颅脑外伤，临床疗效显著，可大大提高患者的存活率，降低并发症发生率，是临床治疗重症颅脑外伤较理想的方法，值得推广应用。

Objective To analyze the clinical effect of craniotomy in the treatment of severe craniocerebral trauma. Methods 60 patients with critical craniocerebral trauma admitted into our hospital from April 2009 to October 2012 were selected as research objects.All patients were applied with large craniectomy.The glasgow coma scale （GCS） before and after surgery was observed and compared as well as the evaluations of clinical effect and complications.Re- suits After surgery,the GCS was increased to （12.57±3.75） point while before treatment it was （5.42±1.44） point,there was statistical difference in GCS before and after treatment （P〈0.05）.The postoperative survival rate reached up to 90.0%.In aspect of postoperative complications,7 cases presented with hydrocephalus,4 cases with cerebrospinal fluid leak,3 cases with encephalocele and 1 case with other complication.Conclusion Application of large craniectomy in the treatment of severe craniocerebral trauma can obtain a remarkable clinical effect.It can greatly improve patient＇s survival rate and reduce the incidence of complications simultaneously,which is an optimum method to treat severe craniocerebral trauma and is worthy of expansion in clinic.