标准大骨瓣减压术和常规骨瓣开颅术治疗重型颅脑损伤的疗效对比

Comparison of Standard Large Bone Flap Decompression and Routine Bone Flap Craniotomy in the Treatment of Severe Craniocerebral Injury

目的比较标准大骨瓣减压术和常规骨瓣开颅术在治疗重型颅脑损伤中的疗效。方法采用随机数字表法将该院神经外科2013年1月—2015年2月收治的90例重型颅脑损伤患者进行分组各45例,对照组为常规骨瓣开颅术,观察组为标准大骨瓣减压术,观察两组患者术后1、3、7 d颅内压变化,以及术后并发症情况。结果两组术后颅内压较术前均明显降低,观察组比对照组颅内压降低幅度大,差异有临床统计学意义(P<0.05);观察组术后并发症总发生率为20.0%,低于对照组的42.22%(χ2=4.1993,P<0.05)。结论标准大骨瓣减压术较常规骨瓣开颅术能够扩大手术视野,减压更彻底,术后并发症发生率低,死亡率低,是临床治疗重型颅脑损伤一种更行之有效的方法,值得临床进一步探讨推广。

Objective To compare the standard big bone flap decompression and conventional bone flap craniotomy in the treatment of severe craniocerebral injury in curative effect. Methods Using a random number table method in our hospital neurosurgery in 2013 January 2015 February 90 cases of severe craniocerebral injury patients were divided into two groups, the control group with conventional bone flap craniotomy, the observation group as the standard big bone flap decompression, were observed in the two groups of patients with postoperative 1,3,7 days intracranial pressure changes, and postoperative complications. Results Two groups of postoperative intracranial pressure was significantly lower in the observation group than in the control group of intracranial pressure was reduced greatly, the difference of clinical statistical significance（P 〈0.05）;observation group Postoperative complication occurrence rate was 20% lower than the control group of 42.22%（χ2=4.1993,P〈0.05）. Conclusion The standard large trauma craniotomy compared with the conventional bone flap craniotomy surgery can expand the operative field, a more thorough decompression, the low rate of postoperative complications and low mortality, is a more effective method for clinical treatment of severe craniocerebral injury, worthy of further clinical investigation and popularization.