重型颅脑损伤去骨瓣减压术联合颞肌切除术的临床疗效

Clinical Efficacy of Decompressive Craniectomy Combined with Temporal Muscle Resection for Severe Craniocerebral Injury

目的探讨去骨瓣减压术联合颞肌切除术治疗重型颅脑损伤患者的临床效果。方法选取2013年8月至2018年8月我院收治的重型颅脑损伤患者146例,随机分为两组各73例。对照组采用去骨瓣减压术治疗,观察组采用去骨瓣减压术联合颞肌切除术治疗,对比两组的瞳孔恢复率、 NIHSS评分、 ADL评分及并发症情况。结果观察组术后瞳孔恢复率明显高于对照组(P <0.05)。术后2周,观察组的NIHSS评分低于对照组, ADL评分高于对照组(P均<0.05)。观察组的术后并发症发生率为9.59%,低于对照组的26.03%(P <0.05)。结论去骨瓣减压术联合颞肌切除术更有利于重型颅脑损伤患者的瞳孔恢复,可改善患者的神经功能及日常生活能力,降低并发症发生率。

Objective To explore the clinical effect of decompressive craniectomy combined with temporal muscle resection in the treatment of patients with severe craniocerebral injury. Methods 146 cases of patients with severe craniocerebral injury admitted to our hospital from August 2013 to August 2018 were selected and randomly divided into two groups, with 73 cases in each group. The control group was treated with decompressive craniectomy, while the observation group was treated with decompressive craniectomy combined with temporal muscle resection. The pupil recovery rate, NIHSS score, ADL score and complications were compared between the two groups.Results The pupil recovery rate of the observation group was significantly higher than that of the control group(P <0.05). 2 weeks after operation, the NIHSS score of the observation group was lower than that of the control group, and the ADL score was higher than that of the control group(both P <0.05). The incidence of postoperative complications of the observation group was 9.59%, lower than 26.03% of the control group(P <0.05). Conclusions Decompressive craniectomy combined with temporal muscle resection is more conducive to pupil recovery in patients with severe craniocerebral injury, which can improve their neurological function and daily living ability, and reduce the incidence of complications.