重型颅脑创伤中标准大骨瓣开颅术的应用

Clinical application of standard large trauma craniotomy for the treatment of severe traumatic brain injury

目的：探讨标准外伤大骨瓣开颅术治疗重型颅脑创伤（TBI）的临床效果。方法以2009年1月至2015年3月我院采用骨瓣开颅术治疗的170例重型颅脑创伤患者为研究对象，随机分为观察组（标准外伤大骨瓣治疗组）86例和对照组(常规骨瓣治疗组)84例，回顾性分析2组术后颅内压控制情况、术后并发症情况及临床治疗效果。结果两组术后颅内压比较，有统计学差异(P＜0.05)；术后6个月随访，观察组总有效为90.7％，对照组为65.4％，2组有统计学差异(P＜0.05)；观察组术后迟发性颅内血肿、急性脑膨出及切口脑脊液漏的发生率低于对照组(P＜0.05)。结论标准外伤大骨瓣开颅术治疗重型TBI，可有效降低术后颅内压，显著改善患者预后，疗效优于常规骨瓣组。

Objective To observe the therapeutic effect of standard large trauma craniotomy in craniotomysevere craniocerebral injury. Methods 170 patients with severe craniocerebral injury were selected as the research objects,86 patients of standard large trauma craniotomy group,84 patients of conventional large trauma craniotomy group,a retrospective analysis was used to observe the situations of intracranial pressure,the therapeutic effect between these two groups.Result There were significant differences in the situation of intracranial pressure after surgery ,the the improvement of clinical effect and the occurrence of complications between these two groups(P< 0.05);Conclusion Standard large trauma craniotomy for treating severe traumatic brain injury safe and effective surgery.