标准大骨瓣减压术对重型颅脑损伤患者颅内压和预后的影响

Standard decompressive craniectomy affect intracranial pressure and prognosis for patients with severe head injury

目的:观察标准大骨瓣减压术对重型颅脑损伤患者颅内压和预后的影响。方法:选取100例重型颅脑损伤患者,随机分为两组,每组50例。对照组接受常规去骨瓣减压术,试验组采取标准大骨瓣减压术。术后通过腰椎穿刺对两组颅内压波动进行监测,并观察两组并发症及手术预后。结果:试验组治疗有效率为88%明显高于对照组的64%(P<0.05);试验组术后第4、6、8天颅内压均明显低于对照组(P<0.05);试验组并发症发生率为8%明显低于对照组的34%,差异有统计学意义(P<0.05)。结论:标准大骨瓣减压术治疗重型颅脑损伤的疗效显著,手术预后好,并发症较少,安全性高,值得推广应用。

objective To explore the Standard decompressive craniectomy on intracranial pressure and prognosis of patients with severe head injury. Method 100 cases of Severe traumatic brain injury patients were randomly divided into two groups,50 cases of each group. The control group received conventional decompressive craniectomy,the experimental group received standard large trauma craniotomy. After sur-gery,the intracranial pressure of the two groups was monitored,the complications and prognosis were observed. Results The experimental group effective rate was 88%,significantly higher than the control group 64%（P〈0. 05）;the experimental group after the first 4,6,8 d in-tracranial pressure was significantly lower than the control group（ P〈0. 05）;in the experiment group the complication rate was 8%,signifi-cantly lower than the control group 34%（ P〈0. 05）. Conclusion Standard decompressive craniectomy on patients with severe traumatic brain injury is significant,surgical prognosis is good,fewer complications,safety,should be widely applied.