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目的探讨标准大骨瓣减压术治疗重型颅脑损伤的临床疗效。方法选取2013年5月—2015年5月邳州市人民医院收治的90例重型颅脑损伤患者,随机分为对照组和观察组,各45例。对照组患者采用常规开颅手术治疗,观察组患者采用标准大骨瓣减压术治疗。比较两组患者颅内压、神经损伤程度、临床疗效及并发症。结果术前两组患者颅内压比较,差异无统计学意义(P>0.05);术后1、3、7 d,观察组患者颅内压均低于对照组(P<0.05)。术前两组患者格拉斯哥预后量表(GOS)评分比较,差异无统计学意义(P>0.05);术后观察组患者GOS评分高于对照组(P<0.05)。观察组患者临床疗效优于对照组,并发症发生率低于对照组(P<0.05)。结论标准大骨瓣减压术治疗重型颅脑损伤的临床疗效确切,能有效降低患者术后颅内压、并发症发生率及减轻神经损伤程度。
Objective To investigate the clinical effect of standard large bone flap decompression in the treatment of severe craniocerebral injury. Methods From May 2013 to May 2015, 90 patients with severe craniocerebral injury admitted to Danzhou People’s Hospital were randomly divided into control group and observation group, with 45 cases in each group. Patients in the control group were treated with conventional craniotomy, and patients in the observation group were treated with standard decompressive craniectomy. Compare the two groups of patients with intracranial pressure, nerve injury, clinical efficacy and complications. Results There was no significant difference in intracranial pressure between the two groups before surgery (P> 0.05). The intracranial pressure of the observation group was lower than that of the control group on the 1st, 3rd, 7th day after operation (P <0.05). There was no significant difference in GOS score between the two groups before surgery (P> 0.05). The GOS score of postoperative observation group was higher than that of control group (P <0.05). The clinical efficacy of the observation group was better than that of the control group, and the complication rate was lower than that of the control group (P <0.05). Conclusion The standard large flap decompression for the treatment of severe craniocerebral injury is effective and can effectively reduce the postoperative intracranial pressure, the incidence of complications and reduce the degree of nerve injury.