改良标准外伤大骨瓣开颅术治疗重型颅脑外伤临床研究

Clinical Study of Modified Standard Traumatic Large Bone Flap Craniotomy for Severe Craniocerebral Trauma

目的探究对重型颅脑外伤患者实施改良标准外伤大骨瓣开颅术的治疗效果。方法随机选取该院在2018年4月—2019年8月期间收治的64例重型颅脑外伤患者采取抽签法分成试验组(n=32)和参照组(n=32),参照组患者采取标准外伤大骨瓣开颅术,试验组患者采取改良标准外伤大骨瓣开颅术,对比两组患者临床治疗有效率、并发症发生情况、手术前后颅内压及GCS评分。结果试验组患者临床治疗有效率的90.62%明显高于参照组的65.62%(χ^2=5.851,P=0.016),试验组患者并发症发生率的18.75%明显低于参照组的50.00%(χ^2=6.926,P=0.008)。两组患者术前GCS评分及颅内压,差异无统计学意义(t=0.018,P=0.985;t=0.037,P=0.971);试验组患者术后5 d颅内压明显为(16.92±2.06)mmHg低于参照组的(19.07±2.39)mmHg(t=3.854,P=0.000),试验组术后3个月GCS评分为(10.29±2.38)分高于参照组的(8.05±2.06)分(t=4.026,P=0.000)。结论对重型颅脑外伤患者实施改良标准外伤大骨瓣开颅术治疗效果显著,可明显提高患者存活率,降低并发症发生率,减少颅内压,促进预后的效果。

Objective To explore the effect of modified standard traumatic large bone flap craniotomy on patients with severe craniocerebral trauma.Methods Randomly select 64 patients with severe craniocerebral trauma admitted in the hospital from April 2018 to August 2019,and were divided into a test group(n=32)and a reference group(n=32)by lottery.In the standard traumatic large bone flap craniotomy,the patients in the experimental group adopted a modified standard traumatic large bone flap craniotomy to compare the clinical treatment efficiency,complications,intracranial pressure and GCS score of the two groups of patients.Results 90.62% of patients in the experimental group had a clinically effective rate that was significantly higher than 65.62% in the reference group(χ^2=5.851,P=0.016),and 18.75%of the complications in the experimental group were significantly lower than 50.00%in the reference group(χ^2=6.926,P=0.008).There was no statistically significant difference in GCS evaluation(t=0.018,P=0.985)and intracranial pressure(t=0.037,P=0.971)between the two groups of patients.The pressure was obviously(16.92±2.06)mmHg lower than the reference group’s(19.07±2.39)mmHg(t=3.854,P=0.000),and the GCS score of the experimental group 3 months after operation was(10.29±2.38)points higher than the reference group’s(8.05±2.06)points(t=4.026,P=0.000).Conclusion The modified standard traumatic large bone flap craniotomy for patients with severe craniocerebral trauma has a significant effect,which can significantly improve the survival rate of patients,reduce the incidence of complications,reduce intracranial pressure,and promote the prognostic effect.