标准去骨瓣减压术联合血肿清除对重症颅脑损伤患者的疗效

Effect of Standard Decompressive Craniectomy Combined with Hematoma Removal on Patients with Severe Craniocerebral Injury

目的:探讨标准去骨瓣减压术联合血肿清除治疗重症颅脑损伤患者的效果.方法:选取2018年1月-2020年1月本院收治的80例重症颅脑损伤患者,按随机数字表法将其分为对照组与观察组,每组40例.对照组进行常规骨瓣开颅术,观察组采取标准去骨瓣减压术联合血肿清除治疗.比较两组手术效果、手术前后颅内压、意识障碍水平及并发症发生情况.结果:观察组手术有效率为65.00%高于对照组的35.00%(P<0.05).术后第7、30天,两组颅内压均低于术前,且格拉斯哥昏迷(GCS)评分均高于术前(P<0.05).术后第7、30天,观察组颅内压低于对照组,且GCS评分高于对照组(P<0.05).观察组并发症发生率为20.00%低于对照组的62.50%(P<0.05).结论:标准去骨瓣血肿清除减压术可在短时间内降低重症颅脑损伤患者的颅内压,改善意识障碍,提高手术效果,降低并发症发生率,值得推广.

Objective:To investigate the effect of standard decompressive craniectomy combined with hematoma removal on the patients with severe craniocerebral injury.Method:A total of 80 patients with severe craniocerebral injury admitted to our hospital from January 2018 to January 2020 were selected and divided into control group and observation group according to the random number table method,40 patients in each group.The control group underwent conventional craniotomy and the observation group underwent standard decompression of bone flap combined with hematoma removal.The effect of operation,intracranial pressure before and after surgery,level of consciousness disturbance and complications were compared between two groups.Result:The effective rate of surgery in the observation group was 65.00%higher than 35.00%in the control group(P<0.05).On the 7th and 30th day after surgery,intracranial pressure in two groups were lower than those before surgery,and Glasgow coma scale(GCS)in two groups were higher than those of before surgery(P<0.05).On the 7th and 30th after surgery,intracranial pressure in the observation group were lower than those in the control group,and GCS score were higher than those in the control group(P<0.05).The complication rate in the observation group was 20.00%lower than 62.50%in the control group(P<0.05).Conclusion:The standard decompressive craniectomy combined with hematoma removal can reduce the intracranial pressure in patients with severe craniocerebral injury in a short time,improve consciousness disorders,improve surgical results,reduce the incidence of complications,which is worthy of promotion.