经额颞顶枕超大骨瓣治疗重型颅脑损伤疗效分析

Analysis of curative effect of large bone flap via frontotemporal top pillow treating patients with severe craniocerebral injury

目的探讨经额颞顶枕超大骨瓣减压联合血肿清除术治疗重型颅脑损伤的临床价值。方法选取2009-01—2013-07我科收治的重型颅脑损伤患者114例,根据治疗方法不同分为2组,观察组64例行经额颞顶枕超大骨瓣手术治疗,对照组50例行标准大骨瓣手术治疗。结果 2组治疗后GCS评分均较治疗前明显提高,观察组改善更为显著。术后随访3个月,观察组患者恢复良好率、轻残率显著高于对照组,重残率与病死率比对照组显著降低。结论经额颞顶枕超大骨瓣治疗重型颅脑损伤,能够耐受麻醉,提倡尽早、积极手术,能够明显改善患者术后GCS评分,改善患者预后,降低重残率与病死率,具有较高临床应用价值。

Objective To investigate the curative effect of large bone flap via frontotemporal top pillow treating patients with severe craniocerebral injury.Methods 114 patients with severe craniocerebral injury in our hospital from January 2009 to July 2013 were divided into the observation group（n=64,treated with large bone flap via frontotemporal top pillow）and the control group（n=50,treated with standard large craniectomy）.Results GCS scores of two groups after treatment were more than these before treatment,especially in the observation group.The results of postoperative follow-up of 3months showed that the recovery and light disability rate of observation group were higher than these of control group,and the severe disability rate and death rate of observation group were lower than these of control group.Conclusion Large bone flap via frontotemporal top pillow has more curative effect on treating patients with severe craniocerebral injury,which can improve the postoperative GCS scores and the prognosis of patients with severe craniocerebral injury.