去骨瓣减压术治疗脑外伤后急性大脑半球肿胀的效果观察

Effect observation of decompressive craniectomy on acute hemispheric swelling after traumatic brain injury

目的探讨去骨瓣减压术治疗脑外伤后急性大脑半球肿胀的临床效果。方法将我院自2013年10月至2016年10月收治的急性颅脑外伤后引起急性大脑半球肿胀患者98例作为研究对象,按照随机数字表法分为研究组和对照组,各49例。研究组患者实施去骨瓣减压术,对照组患者实施常规骨瓣减压术进行治疗,观察两组患者的临床疗效。结果治疗前,两组颅内压差异无统计学意义(P>0.05)。治疗后,两组颅内压较治疗前均降低,且研究组的颅内压低于对照组(P<0.05);研究组GOS 1分占比为16.33%,低于对照组的40.82%,研究组GOS 4~5分占比为59.18%,高于对照组的36.73%(P<0.05),两组GOS 2~3分占比差异无统计学意义(P>0.05)。结论对脑外伤后急性大脑半球肿胀患者实施去骨瓣减压术治疗,临床效果明显,颅内压下降更显著,可推广使用。

Objective To explore the clinical effect of decompressive osteotomy on acute hemispheric swelling after traumatic brain injury. Methods A total of 98 cases of patients with acute cerebral hemispheric swelling after acute craniocerebral trauma admitted from October 2013 to October 2016 in our hospital were enrolled, and randomly divided into study group and control group according to the method of random number table, with 49 cases in each group. The study group was treated with decompressive osteotomy, and the control group was treated with conventional bone flap decompression. The clinical curative effect of the two groups was observed. Results There was no statistical significance in differences of intracranial pressure between the two groups before treatment （P〉0.05）. After treatment, the intraeranial pressure of the two groups decreased compared with those before treatment, and the intracranial pressure of the study group was lower than that of the control group （P〈0.05）. The proportion of GOS 1 in the study group was 16.33%, which was lower than 40.82% in the control group （P〈0.05）, and that of GOS 4-5 in the study group was 59.18%, which was higher than 36.73% in the control group （P〈0.05）. There was no significant difference in GOS 2-3 between the two groups （P〉 0.05）. Conclusion The clinical effect of deeompressive osteotomy applied on acute hemispheric swelling after traumatic brain injury is exact, it can effectively decrease intracranial pressure, which could be popularized.