改良标准大骨瓣开颅术治疗重型颅脑创伤的临床疗效观察

Effect of Modified Standard Large Bone Flap Craniotomy on Severe Craniocerebral Trauma

目的探讨改良标准大骨瓣开颅术治疗重型颅脑创伤的临床疗效。方法选取我院2011年1月—2014年1月收治的重型颅脑创伤患者40例,随机分为对照组和观察组,各20例。对照组患者采用标准大骨瓣开颅术,观察组患者采用改良标准大骨瓣开颅术。比较两组患者治疗前后格拉斯哥昏迷量表(GCS)评分、预后、病死率及并发症发生率。结果两组患者治疗前GCS评分比较,差异无统计学意义(P>0.05);观察组患者治疗后GCS评分高于对照组(P<0.05)。观察组患者预后优于对照组,病死率低于对照组(25.0%比60.0%),并发症发生率低于对照组(15.0%比45.0%)(P<0.05)。结论改良标准大骨瓣开颅术治疗重型颅脑创伤疗效确切,可明显降低患者病死率,改善患者预后。

Objective To investigate the effect of modified standard large bone flap craniotomy on severe craniocerebral trauma. Methods From January 2011 to January 2014,40 patients with severe craniocerebral trauma in our hospital were chosen and randomly divided into control group and observation group,each of 20 cases. Control group given standard large bone flap craniotomy,while observation group given modified standard large bone flap craniotomy. GCS score before and after treatment,prognosis,mortality and incidence of complications between the two groups were compared. Results Before treatment,there was no significant differences of GCS score between the two groups（ P〉0. 05）; after treatment,GCS score of observation group was higher than that of control group（ P〈0. 05）. Prognosis of observation group was better than that of control group,and mortality（ 25. 0% vs. 60. 0%） and incidence of complications（ 15. 0% vs 45. 0%） was lower（ P〈0. 05）,respectively.Conclusion Modified standard large bone flap craniotomy has certain effect on severe craniocerebral trauma,which can effectively reduce the mortality and improve the prognosis.