标准大骨瓣减压治疗重型颅脑损伤的效果研究

Effect research of standard large bone flap decompression for the treatment of severe craniocerebral injury

目的研究标准大骨瓣减压术在重型颅脑损伤中的应用价值。方法以2013年11月~2017年12月本院接诊的重型颅脑损伤病患80例为研究对象,利用电脑随机双盲法将之分成实验组和对照组,每组40例。实验组实行标准大骨瓣减压术治疗,对照组实行常规颞顶骨瓣开颅术治疗。观察两组术后颅内压的改善情况,比较恢复良好率等指标。结果实验组的死亡率为2.5%、并发症发生率为12.5%,明显比对照组的10.0%、35.0%低,组间差异有统计学意义(P<0.05)。实验组的恢复良好率为50.0%,明显比对照组的27.5%高,组间差异有统计学意义(P<0.05)。实验组术后1、5d的颅内压均明显比对照组低,组间差异有统计学意义(P<0.05)。结论积极对重型颅脑损伤患者施以标准大骨瓣减压术治疗,可有效促进其颅内压降低,减少并发症发生风险,提高生存质量,改善预后效果。

Objective To study the application value of standard large bone flap decompression in severe craniocerebral injury. Methods From November 2013 to December 2017,80 patients with severe craniocerebral injury were randomly divided into experimental group and control group with 40 cases in each group.The experimental group was treated with standard large bone flap decompression,and the control group with routine temporoparietal bone flap craniotomy.The improvement of intracranial pressure was observed and the recovery rate was compared between the two groups. Results The mortality of the experimental group was 2.5% and the incidence of complications was 12.5%,which was significantly lower than that of the control group（10.0%,35.0%,P〈0.05）.The recovery rate of the experimental group was 50.0%,which was significantly higher than that of the control group（27.5%）.The difference between the two groups was statistically significant（P〈0.05）.The intracranial pressure in the experimental group was significantly lower than that in the control group on the 1 st and 5 th day after operation,and the difference between the two groups was statistically significant（P〈0.05）. Conclusion Active treatment of severe craniocerebral injury with standard large trauma craniotomy can effectively promote the intracranial pressure reduction,reduce the risk of complications,improve the survival quality and improve the prognosis effect.