改良去骨瓣开颅术和传统去骨瓣开颅术治疗重型颅脑外伤的临床效果对比

Comparison of the Clinical Effects Between Modified Craniotomy and Craniotomy on Severe Craniocerebral Trauma

目的探讨改良去骨瓣开颅术和传统去骨瓣开颅术治疗重型颅脑外伤的临床效果。方法选取我院2013年6月—2017年6月收治的60例重型颅脑外伤患者为本研究对象,将所有患者根据治疗方法不同分为两组,观察组30例给予改良去骨瓣开颅术治疗,对照组30例给予传统去骨瓣开颅术治疗,对比两组患者术后1 d、3 d、7 d颅内压以及术后3个月预后情况。结果术后1 d、3 d、7 d,观察组患者颅内压(270.0±26.5)mmHg、(239.7±28.7)mmHg、(226.3±11.0)mmHg均低于对照组的(435.8±40.0)mmHg、(407.9±24.7)mmHg、(331.4±31.2)mmHg,差异具有统计学意义(t=18.956 4、24.330 2、17.400 7,P<0.05);观察组患者术后3个月GOS评分总有效率为86.67%,明显高于对照组的66.67%,差异具有统计学意义(χ~2=11.181 2,P<0.05)。结论改良去骨瓣开颅术治疗重型颅脑外伤的临床效果优于传统去骨瓣开颅术,可进一步改善患者颅内压,并促进患者预后。

Objective To investigate the clinical effects of modified craniotomy and craniotomy on craniocerebral trauma. Methods Sixty patients with severe craniocerebral trauma who were admitted to our hospital from June 2013 to June 2017 were enrolled in this study. Allpatients were divided into two groups according to the different treatment methods. Thirty patients in the observation group were treated with modifed craniotomy was performed. Thirty patients in the control group were treated by conventional craniotomy. The intracranial pressure at 1, 3 and 7 days after operation and the prognosis at 3 months after operation were compared. Results 1 d, 3 d, 7 d after operation, the intracranial pressures were （270.0 ± 26.5） mmHg, （239.7 ± 28.7） mmHg and （226.3 ± 11.0） mmHg in the observation group, which were significantly lower than those in the control group of （435.8±40.0） mmHg, （407.9±24.7）mmHg, （331.4±31.2） mmHg, the difference was statistically signifcant （ t = 18.9564, 24.3302, 17.4007, P 〈 0.05）. The total effective rate of GOS score was 86.67% at 3 months after operation in observation group, which was signifcantly higher than that in control group of 66.67%, the difference was statistically signifcant （χ2 = 11.181 2, P 〈 0.05）. Conclusion The clinical effect of modifed craniotomy for treatment of severe traumatic brain injury is better than that of traditional craniotomy, which can further improve the intracranial pressure and promote the prognosis of patients.