急性硬膜下血肿伴脑水肿的手术治疗效果分析

Effect analysis of surgical treatment of acute subdural hematoma accompanied with cerebral edema

目的探讨急性硬膜下血肿(ASDH)伴脑水肿的手术治疗方法与临床效果,为改善患者治疗预后提供依据。方法选取2014年1月~2017年2月我院神经外科收治的符合病例选择标准的86例ASDH伴脑水肿患者作为研究对象,按照随机数字表法将其分为A组(行标准外伤大骨瓣开颅术)与B组(行常规骨瓣开颅术),每组各43例。进行术后随访,观察两组患者的并发症发生情况,采用格拉斯哥预后评分系统(GOS)评价两组患者的治疗结局。结果 A组患者仅发生1例急性脑膨出,术后并发症发生率为2.33%,B组患者的并发症发生率为13.95%,两组患者的并发症发生率比较,差异有统计学意义(P<0.05)。A组患者的治疗结局优于B组,差异有统计学意义(P<0.05)。结论对ASDH伴脑水肿患者,尽早实施标准外伤大骨瓣开颅术能够有效改善预后质量,降低并发症发生率,值得临床推广应用。

Objective To explore the surgical treatment and clinical effect of acute subdural hematoma （ASDH） accom- panied with cerebral edema so as to provide evidence for improving the patients＇ prognosis. Methods Ahogether 86 cases of ASDH accompanied with cerebral edema who were treated in Department of Neurosurgery of our hospital from January 2014 to February 2017 and qualified for case selection criteria were selected as subjects and divided into group A （standard large trauma eraniotomy） and group B （conventional eraniotomy） according to the random number table method, 43 cases in each group. The postoperative follow-up was carried out to observe the complications and the prognostic score system （COS） was used to evaluate the outcome of treatment in the two groups. Results Only 1 case of acute eneephaloeele occurred in group A, the incidence of postoperative complications of group A was 2.33%, and the incidence of complications of group B was 13.95%. Two groups had statistically significant difference in the incidence of complications （P〈0.05）. The treatment outcome of group A was superior to that of group B, the difference was statis- tically significant （P〈0.05）. Conclusion The early implementation of standard large trauma craniotomy for ASDH pa- tients accompanied with cerebral edema can effectively improve the quality of the prognosis and reduce the incidence of complications, which is worthy of clinical application .