标准去大骨瓣减压手术治疗重型颅脑损伤的临床疗效和安全性

Clinical Efficacy and Safety of Criteria to Hemicraniectomy Surgery in the Treatment of Severe Traumatic Brain Injury

目的探讨标准去大骨瓣减压手术治疗重型颅脑损伤的临床疗效和安全性。方法选取我院2013年1月～2015年12月收治入院的重型颅脑损伤患者100例作为研究对象,根据治疗中选用的手术方式分为观察组和对照组,对照组50例应用骨瓣开颅术,观察组50例应用标准去大骨瓣减压法,统计术后的GOS分数,并对比组间术后恢复情况。结果观察组术后第1、3、7天颅内压监测均低于对照组,两组差异均有统计学意义(P<0.05);术后观察组的GOS分数明显升高,达到(11.3±3.2)分,高于对照组(P<0.05);术后标准组的的恢复情况较为理想,1级占比达到56.0%,高于常规组(P<0.05),5级占比为6.0%,低于常压组(P<0.05)。结论在颅脑外伤的治疗中应用标准去大骨瓣减压法获得的术后效果更好,与骨瓣开颅术相比,具有恢复快、致死率低等优点。

Objective To investigate the clinical efficacy and safety of criteria to large craniectomy in treatment of severe brain injury. Methods From January 2013 to December 2015, 100 cases of patients with severe brain injury in our hospital were selected as the study object, according to the choice of surgical treatment, 100 cases were divided into observation group and control group, 50 cases of control group were treated with bone craniotomy, 50 cases of observation group were treated with the standard to hemicraniectomy, to survey the postoperative GOS scores and to compare the postoperative recovery of two groups. Results The intracranial pressure monitoring of the postoperative day 1,3,7were lower than those of control group, the difference was statistically significant（P〈0.05）. The postoperative group GOS scores increased to（ 11.3±3.2） points, higher than that of control group（P〈0.05）; postoperative recovery criteria group is more ideal, the 1 level accounted for 56.0%, higher than that of the normal group（P.0.05）, the 5 levels accounted for 6.0%, lower than that of the atmospheric pressure group（P〈0.05）. Conclusion The application of criteria to hemicraniectomy in the treatment of traumatic Brain injury has good effect, compared with the craniotomy, which can make patients a quick recovery, decrease the death rate and so on.