标准去大骨瓣减压术结合阶梯式减压治疗危重颅脑外伤的效果分析

Effect analysis of standard decompressive craniectomy combined with stepped decompression in the treatment of severe craniocerebral trauma

目的分析神经外科危重颅脑外伤的临床治疗方法及效果。方法120例危重颅脑外伤患者,根据手术方式不同分为对照组和研究组,每组60例。对照组患者采取常规去骨瓣开颅手术治疗,研究组患者采取标准去大骨瓣减压术结合阶梯式减压治疗。对比两组患者手术前后颅内压水平、并发症发生情况、格拉斯哥预后量表(GOS)分级情况。结果术前,两组患者的颅内压水平比较差异无统计学意义(P>0.05);术后1 d、3 d、1周,研究组患者的颅内压水平均低于对照组,差异具有统计学意义(P<0.05)。研究组患者的并发症发生率5.00%低于对照组的16.67%,差异具有统计学意义(χ^(2)=4.227,P=0.040<0.05)。研究组患者的GOS分级优于对照组,差异具有统计学意义(P<0.05)。结论采取标准去大骨瓣减压术结合阶梯式减压治疗危重颅脑外伤患者,能有效改善患者的颅内压,减少并发症的发生,促使患者术后转归良好。

Objective To analyze the effect of standard decompressive craniectomy combined with stepped decompression in the treatment of severe craniocerebral trauma.Methods A total of 120 patients with severe craniocerebral trauma were divided into control group and research group according to different surgical methods,with 60 cases in each group.The control group was treated with conventional craniotomy,and the research group was treated with standard decompressive craniectomy combined with stepped decompression.The intracranial pressure level before and after operation,occurrence of complications and Glasgow outcome scale(GOS)grading were compared between the two groups.Results Before operation,there was no statistically significant difference in intracranial pressure levels between the two groups(P>0.05).1 d,3 d and 1 week after operation,the intracranial pressure levels of the research group was lower than those of the control group,and the difference was statistically significant(P<0.05).The incidence of complications 5.00%of the research group was lower than 16.67%of the control group,and the difference was statistically significant(χ^(2)=4.227,P=0.040<0.05).The GOS grading in the research group was better than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Combination of standard decompressive craniectomy and stepped decompression can effectively improve the intracranial pressure of patients with severe craniocerebral trauma,reduce the occurrence of complications,and promote the postoperative outcome of patients.