预见性平衡双侧去骨瓣减压术联合着力部位硬膜外血肿清除术对重型对冲性颅脑损伤的影响研究

Effect of predictive balanced bilateral bone flap decompression combined with epidural hematoma removal in focus areas on severe contre-coup brain injury

目的探讨预见性平衡双侧去骨瓣减压术联合着力部位硬膜外血肿清除术对重型对冲性颅脑损伤的影响。方法选取2016年4月—2018年4月期间在我院治疗的54例重型对冲性颅脑损伤患者,按随机数字表法分成2组各27例。对照组行单侧额颞部开颅血肿清除术联合双侧去骨瓣减压术,观察组行预见性平衡双侧去骨瓣减压术联合着力部位硬膜外血肿清除术,比较2组术后7 d颅内压及GCS评分及并发症发生率。结果相比对照组,观察组颅内压较低,GCS评分较高,并发症发生率较低,差异均有统计学意义(P<0.05)。结论预见性平衡双侧去骨瓣减压术联合着力部位硬膜外血肿清除术治疗重型对冲性颅脑损伤可有效降低颅内压,改善昏迷情况,减少并发症发生。

Objective To investigate the effect of predictive balanced bilateral bone flap decompression combined with epidural hematoma removal in focus areas on severe contre-coup brain injury.Methods 54 patients with severe contre-coup brain injury treated in the hospital from April 2016 to April 2018 were selected,and they were divided into two groups by random number table,with 27 cases in each group.Control group was given bilateral frontotemporal craniotomy evacuation of hematoma combined with bilateral bone flap decompression,while observation group was given predictive balanced bilateral bone flap decompression combined with epidural hematoma removal in focus areas.The postoperative 7d intracranial pressure,Glasgow coma score and incidence of complications were compared between the two groups.Results Compared with control group,the intracranial pressure of observation group was lower,the Glasgow coma score of observation group was higher,and the incidence of complications in observation group was lower(P<0.05).Conclusion Predictive balanced bilateral bone flap decompression combined with epidural hematoma removal in focus areas in treatment of severe contre-coup brain injury can effectively decrease intracranial pressure,improve the situations of coma,and reduce the incidence of complications.