大骨瓣减压与常规骨瓣减压治疗重型颅脑损伤的对照研究

Large bone flap decompression with conventional bone disc decompression treatment of severe craniocerebral injury clinical control study

目的探讨大骨瓣减压与常规骨瓣减压治疗重型颅脑损伤的临床效果。方法随机将重型颅脑损伤136例分两组,每组68例。观察组采用标准大骨瓣减压治疗,对照组采用常规骨瓣减压治疗。比较两组临床疗效,治疗前后神经功能缺损评分和格拉斯哥预后分级评分(GOS),观察术前和术后第1、3、7天颅内压变化情况。结果 1观察组良好率(51.47%)显著高于对照组(19.12%),差异有统计学意义(P<0.05);2两组术前颅内压比较差异无统计学意义(P>0.05),两组术后第1、3、7天颅内压较术前显著降低(P<0.05),且观察组颅内压降低幅度优于对照组(P<0.05);3治疗后,观察组患者神经功能缺损评分、GOS改善程度、并发症发生率显著优于对照组(均P<0.05)。结论采用大骨瓣减压治疗重型颅脑损伤,能够明显降低术后颅内压,显著改善患者预后效果,值得在临床中推广应用。

Objective To study the big bone flap decompression with conventional bone disc decompression for treatment of severe head injury. Methods 136 cases of severe craniocerebral injury patients were randomly divided into two groups, 68 cases in each group. Observation group with a standard big bone flap subjected to decompression therapy and the control group B with normal bone disc subjected to decompression therapy. Compare two groups of clinical curative effect, neural function defect scale before and after the treatment and prognosis of Glasgow grading scores, observe the preoperative and postoperative intracranial pressure changes in 1,3, 7 days. Results （~）The cure rate of observation group （ 51.47% ） was significantly higher than that of control group （ 19.12% ） （ P 〈 O. 05 ） ; ~）The preoperative intracranial pressure between the two groups had no statistical significance （ P 〉 0.05 ）, two groups of postoperative intracranial pressure 1, 3, 7 days a preoperative decreased significantly （ P 〈 0.05 ）, intracranial pressure reduction due to the control group and observation group （ P 〈 0.05 ） ; （~）After treatment, the observation group of patients with nerve function defect score, GOS score improvement degree, complication incidence was significantly better than that of control group （ all P 〈 0.05）. Con- clusion The big bone flap decompression treatment of severe head injury, can significantly reduce postoperative intracranial pressure, the prognosis of patients with significant improvement effect, is worth popularizing in clinical application.