66例颅脑损伤患者手术治疗分析

Analysis of on the surgical treatment of 66 patients with craniocerebral injury

目的:探讨去骨瓣减压手术在重型颅脑损伤患者中的治疗效果。方法:对重型颅脑损伤患者66例按照入院顺序号及手术方式分研究组(33例)与对照组(33例),对照组实施常规的去骨瓣减压手术,研究组运用标准去骨瓣减压手术,比较两组治疗前后格拉斯哥昏迷(GCS)评分、颅内压变化及两组的治疗有效率、病死率、并发症发生率以及ADL分级。结果:研究组治疗总有效率78.8%,高于对照组60.6%(P<0.05)。术前两组患者GCS评分无差异,治疗后两组GCS评分均较治疗前提高(P<0.05),且研究组明显高于对照组(P<0.05)。研究组术后并发症发生率明显低于对照组(P<0.05)。研究组与对照组存活患者的ADLⅠ级差异有统计学意义(P<0.05)。结论:标准去骨瓣减压手术用于重型颅脑损伤患者的治疗,可以降低并发症及病死率,提高临床疗效。

Objective：To investigate the effect of treatment of bone flap decompression surgery in patients with severe craniocerebral injury.Methods：66patients with craniocerebral injury were randomly divided into the study group（33cases）and the control group（33cases）according to the order of admission and surgery.In the control group,they were received conventional treatment of bone flap decompression surgery while in the study group,they were treated with the bone flap decompression surgery.Then,the glasgow coma（GCS）score,intracranial pressure changes before and after treatment of two groups and the treatment effect,mortality,complication rate,and ADL grade of two groups were compared.Results：The response rate in the study group was 78.8%,which was higher than that in the control group of 60.6%（P〈0.05）.There was no difference in GCS score between the two groups before operation.After treatment,the GCS score of the two groups were significantly higher than before treatment（P〈0.05）,and the study group was significantly higher than that in the control group（P〈0.05）.In addition,the incidence of postoperative complications in the study group was significantly lower than that in the control group（P〈0.05）.The difference of the grade ADL grade I in the study group and the control group had significantly different（P〈0.05）.Conclusion：The application of standard bone flap decompression surgery in treatment of patients with severe craniocerebral injury can reduce the incidence of complications and mortality and improve the clinical effect.