双侧去骨瓣和改良大骨瓣开颅减压术治疗急性颅脑损伤的效果比较

Effect comparison of bilateral flap resection and improved craniotomy with large flap resection in the treatment of acute craniocerebral injury

目的探讨双侧去骨瓣和改良大骨瓣开颅减压术治疗急性颅脑损伤的效果。方法选取2013年12月~2016年12月在我院接受治疗的急性颅脑损伤患者84例,按随机数字法将其分为观察组、对照组,每组42例。对照组患者采用改良大骨瓣开颅减压术进行治疗,观察组采用双侧去骨瓣减压术进行治疗。比较两组患者治疗前后的GCS评分,两组患者治疗前和治疗后3、7 d的颅内压,预后情况。结果观察组患者治疗后的GCS评分明显高于对照组,差异有统计学意义(P<0.05);观察组治疗后3、7 d的颅内压均明显低于对照组,差异有统计学意义(P<0.05);观察组患者的预后情况明显优于对照组,差异有统计学意义(P<0.05)。结论与改良大骨瓣开颅减压术比较,应用双侧去骨瓣减压术治疗急性颅脑损伤的效果更显著,可降低患者颅内压,且治疗过程中患者发生恶化的可能性更低,更有利于推进患者的恢复进程,值得临床推广应用。

Objective To investigate the effect of bilateral flap resection and improved craniotomy with large flap resec- tion in the treatment of acute craniocerebral injury.Methods 84 patients with acute craniocerebral injury treated in our hospital from December 2013 to December 2016 were selected.According to the random number method,the patients were divided into observation group and control group,with 42 patients in each group.The patients in the control group were treated with modified large bone flap craniotomy,and the observation group was treated with bilateral flap resec- tion craniectomy.GCS score before and after treatment,the intracranial pressure before treatment and 3 d and 7 d after treatment and the prognosis were compared between the two groups.Results GCS score in the observation group was obviously higher than that in the control group after treatment,and the difference was statistically significant （P〈0.05）. The intracranial pressure in the observation group was obviously lower than that in the control group after 3 d and 7 d treatment,and the difference was statistically significant （P〈0.05）.The prognosis in the observation group was better than that in the control group,and the difference was statistically significant （P〈0.05）.Conclusion Compared with improved craniotomy with large flap resection,the application of bilateral bone flap resection craniotomy in the treatment of acute eraniocerebral injury is more significant,which can reduce the intracranial pressure of patients.During the treatment,the possibility of deterioration is the lower, which is more conducive to promoting the recovery process of patients and there- fore is worthy of clinical application and promotion.