去大骨瓣减压术与快速单层关颅术治疗弥漫性脑肿胀术中急性脑膨出的临床对比观察

A clinical comparative study on decompressive craniectomy and quick single off craniotomy in treatment of dramatic expansion with diffuse brain swelling

目的对比观察去大骨瓣减压术与快速单层关颅术治疗弥漫性脑肿胀术中急性脑膨出的临床效果。方法选取2014年5月至2016年5月收治的弥漫性脑肿胀术中急性脑膨出患者80例,依据随机数字表法将这些患者分为去大骨瓣减压术组(n=40)和快速单层关颅术组(n=40)两组,快速单层关颅术组患者接受快速单层关颅术治疗,去大骨瓣减压术组患者接受去大骨瓣减压术治疗,对两组患者的临床疗效、不良反应发生情况进行统计分析。结果去大骨瓣减压术组患者的恢复良好率(22.5%,9/40)、轻度残疾率(45.0%,18/40)均显著高于快速单层关颅术组(7.5%,3/40;22.5%,9/40;P<0.05),重度残疾率(17.5%,7/40)、植物生存率(10.0%,4/40)均显著低于快速单层关颅术组(42.5%,17/40;20.0%,8/40;P<0.05),不良反应发生率(5.0%,2/40)显著低于快速单层关颅术组(17.5%,7/40,P<0.05)。结论相比快速单层关颅术,去大骨瓣减压术治疗弥漫性脑肿胀术中急性脑膨出的临床效果更好,不良反应发生率更低。

Objective To observe and compare the clinical effect of decompressive craniectomy and quick single off craniotomy in treatment of acute brain expansion in diffuse brain swelling surgery.Methods 80 patients with dramatic expansion during diffuse brain swelling surgery treated in this hospital during May 2014 to May 2016 were selected for this study, these patients were divided into decompressive craniectomy group （n=40） and quick single off cranial surgery group （n=40） according to the random number table, patients in quick single off craniotomy group were treated with quick single off craniotomy, while patients in decompressive craniectomy group were given with decompressive craniectomy, the clinical efficacy, adverse events of these two groups were statistically analyzed.Results The rate of good recovery and mild disability rate in patients of decompressive craniectomy group were 22.5% （9/40） and 45.0% （18/40） respectively, they were significantly higher than those [7.5% （3/40） and 22.5% （9/40）] of quick single off craniotomy （P〈0. 05）, the severe disability rate 17.5% （7/40） and plant survival rate 10.0% （4/40） were significantly lower than those [42.5 % （17/40） and 20.0% （8/40）] of quick single off craniotomy （P〈0. 05）, and its incidence of adverse reactions [5.0% （2/40）] was significantly lower than that [17.5% （7/40）] of quick single off craniotomy grouup （P〈0. 05）.Conclusion In comparison with quick single off craniotomy, the clinical effect of decompressive craniectomy in treatment of dramatic expansion during diffuse brain swelling surgery is better, and the incidence of adverse reactions is lower.