标准外伤大骨瓣开颅术治疗重型颅脑损伤合并脑疝30例分析框架

Analysis Frame of Standard Traumatic Large Bone Flap Craniotomy for Severe Head Injury Combined with Cerebral Hernia

目的对标准外伤大骨瓣开颅术治疗重型颅脑损伤合并脑疝30例进行研究分析。方法研究对象选取2017年2月—2019年11月,在该院进行标准外伤大骨瓣开颅术治疗的重型颅脑损伤合并脑疝30例,归为研究组,与同期在该院使用常规骨瓣开颅手术进行治疗的30例患者,归为对比组,比较两组患者的并发症发生情况、两组患者的临床疗效、两组患者手术前后的颅内压。结果研究组的并发症发生情况(10.00%)要低于对比组(33.33%)(χ~2=4.810,P=0.030);研究组的存活率(90.00%)要高于对比组(63.33%)(χ~2=5.960,P=0.010);两组患者开颅前的颅内压差异无统计学意义(t=0.440,P=0.660);术后3 d,研究组的颅内压低于对比组(t=7.350,P=0.000);术后7 d,研究组的颅内压明显低于对比组(t=8.850,P=0.000)。结论使用标准外伤大骨瓣开颅术来治疗重型颅脑损伤合并脑疝患者,能够有效将患者的并发症发生几率减小,促进患者康复,提高治疗效果,降低患者的病死率,提高患者的存活率,并有效改善患者的预后,降低颅内压,具有较高的临床应用价值。

Objective To study and analyze 30 cases of severe traumatic brain injury complicated with cerebral hernia by standard traumatic large bone flap craniotomy.Methods The study subjects were selected from February 2017 to November 2019.30 patients with severe traumatic brain injury and cerebral hernia who underwent standard traumatic large bone flap craniotomy in the hospital were included in the research group.The 30 patients treated with bone flap craniotomy were grouped into a comparison group,comparing the complications of the two groups,the clinical efficacy of the two groups of patients,and the intracranial pressure of the two groups of patients before and after the operation.Results The incidence of complications in the study group(10.00%)was lower than that in the comparison group(33.33%)(χ2=4.810,P=0.030);the survival rate of the study group(90.00%)was higher than that in the comparison group(63.33%)(χ2=5.960,P=0.010);The difference in intracranial pressure before craniotomy was not sta tistically significant between the two groups(t=0.440,P=0.660);three days after surgery,the intracranial pressure in the study group was lower than that in the comparison group(t=7.350,P=0.000);7 d after surgery,the intracranial pressure in the study group was significantly lower than that in the control group(t=8.850,P=0.000).Conclusion The use of standard traumatic large bone flap craniotomy to treat patients with severe craniocerebral injury combined with cerebral hernia can effectively reduce the incidence of complications for patients,promote patient recovery,improve treatment effect,reduce patient mortality and increase the survival rate,and effectively improve the prognosis of patients,reduce intracranial pressure,has high clinical application value,it is worth popularizing.