不同手术治疗方法对急性颅脑损伤的疗效对比研究

Comparative analysis of effects of different surgical methods on treatment of acute craniocerebral injury

目的 探讨双侧去骨瓣与改良大骨瓣开颅减压术对急性颅脑损伤的临床治疗效果。方法 选取2014年10月~2015年10月本院诊治的60例急性颅脑损伤患者,随机将患者分为对照组和试验组,对照组采用改良大骨瓣开颅减压术治疗,试验组采用双侧去骨瓣减压术治疗,比较两组临床疗效。结果 两组治疗前GCS评分差异没有统计学意义（P〉0.05）;试验组治疗后GCS评分显著高于对照组（P〈0.05）;两组治疗前颅内压比较差异不显著（P〉0.05）;试验组治疗后3 d和7 d颅内压显著低于对照组（P〈0.05）;试验组重度残疾、植物生存、死亡的比率显著低于对照组（P〈0.05）。结论 急性颅脑损伤患者采用双侧去骨瓣减压术治疗效果理想,能更有效降低颅内压,改善患者预后,值得推广应用。

Objective To explore the clinical efficacy of bilateral decompressive craniectomy and improved large bone flap decompression on the treatment of acute craniocerebral injury. Methods A total of 60 patients with acute craniocerebral injury admitted to our hospital from October 2014 to October 2015 were selected and randomly divided into a control group and an experimental group. The control group was treated with improved large bone flap decompression and the experimental group with bilateral decompressive craniectomy, and the efficacies in the two groups were compared. Results There was no significant difference between the GCS scores in the two groups before the treatment（P 〉 0.05）; after the treatment, the GCS score in the experimental group was much higher than that in the control group （P 〈 0.05）; there was no obvious difference between the intracranial pressures in the two groups before the treatment （P 〉 0.05）; three and seven days after the treatment, the intracranial pressure in the experimental group was much lower than that in the control group （P 〈 0.05）; the ratio of severe disability, vegetative state and death was significantly lower than that in the control group （P 〈 0.05）. Conclusion The treatment of acute craniocerebral injury with bilateral decompressive craniectomy shows ideal effect, can greatly lower the intracranial pressure and improve patient outcome and is worth popularizing and applying.