对冲性重型颅脑损伤双侧去骨瓣减压临床疗效分析

Clinical effect analysis of bilateral bone flap decompression in the treatment of severe craniocerebral injury

目的探讨双侧去骨瓣减压术治疗对冲性重型颅脑损伤的临床疗效。方法选取60例对冲性重型颅脑损伤患者,随机分为研究组与对照组。研究组30例,行双侧去骨瓣减压术,对照组行标准单侧外伤大骨瓣开颅术。记录患者不同时期的颅内压及GCS评分,并观察急性脑膨出和切口疝发生情况,术后随访3个月,比较临床疗效。结果术后第1天开始,研究组颅内压均显著低于对照组,术后第7天开始,研究组GCS显著高于对照组,P<0.05。研究组良好率明显高于对照组,死亡率显著低于对照组,临床疗效更好,P<0.05。结论双侧去骨瓣减压术应用于对冲性重型颅脑损伤临床治疗中,意识恢复速度快,临床疗效肯定,并发症发生率低,安全性更高。

Objective ： To investigate the clinical effect of bilateral bilateral bone flap decompression in the treatment of severe craniocerebral injury. Methods： Sixty patients with severe brain injury were randomly divided into study group and control group. In the study group, 30 cases were treated with bilateral decompression of the bone flap, and the control group were treated with large bone flap. Intracranial pressure and Glasgow Coma Scale （GCS） were recorded in different periods to observe the acute brain swelling and ineisional hernia incidence, postoperative follow-up was 3 months, the clini- cal efficacy was compared. Results ： Since the first day after operation, the intraeranial pressure in the study group was sig- nificantly lower than that in the control group. After the seventh days after the operation, the study group GCS was signifi- cantly higher than that in the control group, P 〈 0. 05. The good rate of the study group was significantly higher than that of the control group, the mortality rate was significantly lower than that of the control group, and the clinical effect was better, P 〈0. 05. Conclusion： Bilateral decompression of the bone flap in the treatment of severe traumatic brain injury in clinical treatment proves to have the fast recovery rate, clinical efficacy, low incidence of complications and high safety.