标准外伤大骨瓣与常规骨瓣治疗重型颅脑损伤的疗效比较

Standard large trauma craniotomy versus conventional bone flap craniotomy in treatment of patients with severe craniocerebral injury

目的比较标准外伤大骨瓣减压术与常规骨瓣治疗术治疗重型颅脑损伤患者的临床疗效。方法选取88例重型颅脑损伤患者,按照随机双盲法分为对照组(n=44)和观察组(n=44)。对照组患者采用常规骨瓣减压术治疗,观察组患者采用标准外伤大骨瓣减压术治疗。比较2组患者临床疗效、并发症发生率以及治疗前后格拉斯哥昏迷(GCS)评分和颅内压变化。结果观察组总有效率显著高于对照组,而并发症发生率显著低于对照组(P <0. 05)。治疗后,观察组GCS评分和颅内压水平显著优于对照组(P <0. 05);观察组患者脑水肿体积和中线移位情况均显著优于对照组(P <0. 05)。结论标准外伤大骨瓣减压术治疗重型颅脑损伤患者安全有效,可改善预后,降低死亡率和并发症发生率。

Objective To compare the effect of standard large trauma craniotomy and conventional bone flap craniotomy in treatment of patients with severe craniocerebral injury. Methods Eighty-eight patients with severe craniocerebral injury were selected and randomly divided into control group （ n =44） and observation group （ n =44）. The control group was treated with conventional bone flap craniotomy, and the observation group was treated with standard large trauma craniotomy. Clinical efficiency, incidence rate of complications, the score of Glasgow Coma Scale （GCS） and intracranial pressure before and after treatment were compared. Results The total effective rate of the observation group was significantly higher than that of the control group, and the incidence rate of complications was significantly lower than that of the control group （ P 〈0.05）. After treatment, the GCS score and intracranial pressure of the observation group were significantly better than those of the control group （ P 〈0.05）, and the brain edema volume and midline displacement of the observation group were significantly better than those of the control group （ P 〈0.05）. Conclusion Standard large trauma craniotomy is effective and safe in treatment of patients with severe craniocerebral injury, which can improve prognosis, reduce mortality and incidence rate of complications.