不同骨瓣减压术治疗重度颅脑损伤的对照研究

A control study of different bone flap craniotomy in the treatment of severe traumatic brain injury

目的对比分析标准大骨瓣减压术与常规骨瓣减压术治疗重度颅脑损伤的效果。方法选取深圳市宝安区福永人民医院2012年1月至2014年12月收治的170例重度颅脑损伤患者(GCS≤8)为研究对象,按不同术式分为常规组85例及标准组85例。常规组患者给予常规骨瓣减压术治疗,标准组给予标准大骨瓣减压术治疗。观察比较两组患者围术期各临床病理生理参数、临床疗效及并发症发生率。结果标准组手术时间显著高于常规组(P<0.05),术中出血量、颅内压恢复平稳时间、住院时间显著低于常规组(P<0.05)。标准组临床疗效显著优于常规组(U=12.794,P=0.000),并发症发生率高于常规组,但差异未见统计学意义(χ2=0.776,P=0.509)。结论标准大骨瓣减压术临床疗效确切、安全性高,值得在临床上推广应用。

Objective To compare and analyze the effects of standard large bone flap craniotomy and routine bone flap craniot- omy on severe traumatic brain injury. Methods One hundred and seventy patients with severe traumatic brain injury （GCS≤8） from January 2012 to December 2014 were selected as the research objects and divided into routine group （ n = 85 ） and the standard group （ n = 85 ） according to the different operation mode. Patients in the routine group were treated by the routine bone flap crani- otomy, while patients in the standard group were given standard large bone flap eraniotomy. The clinical pathological and physiolog- ical parameters of the patients in each group in peroperative period were compared. The clinical efficacy and complication rate were also compared. Results The operation time in the standard group was significantly longer than that in the routine group （P 〈 0. 05 ） , but the amount of bleeding in the operation, the steady recovery time of intracranial pressure and the hospitalization time in the standard group were significantly shorter than those in the routine group （ P 〈 0. 05 ）. The clinical curative effect of standard group was significantly higher than that of conventional group （ U = 12. 794, P 〈 0. 001 ）. The complication rate in the standard group was higher than that in the routine group, but the difference was not significant （ X^2 = 0. 776 ,P = 0. 509）. Conclusion The clinical curative effect of standard lame bone tan craniotomv is excellent and safe. which is worth clinical annlication.