双侧开颅术治疗重型颅脑损伤临床效果观察.docVIP

双侧开颅术治疗重型颅脑损伤临床效果观察 　　[摘要] 目的 探讨双侧开颅术治疗重型颅脑损伤的临床效果。 方法 选取50例行双侧开颅术治疗的重型颅脑创伤患者作为研究对象，记录患者术后第1天、第3天、第7天的颅内压变化情况，并于术后6个月进行随访，对身体恢复情况进行评分，总结治疗体会。 结果 术后第1天、第3天、第7天患者的颅内压呈下降趋势。患者中死亡3例，占6.00%；恢复良好24例，占48.00%；中等残疾16例，占32.00%；重度残疾6例，占12.00%；处于植物状态1例，占2.00%。 结论 对有双侧开颅指征的重型颅脑损伤患者早期进行双侧开颅手术，能有效提高救治效果，降低致残率和死亡率，是救治重型颅脑损伤的有效方法，但需严格把握手术指征和做好围术期工作。 　　[关键词] 双侧开颅术；重型颅脑损伤；临床效果 　　[中图分类号] R651.15 [文献标识码] B [文章编号] 1673-9701（2015）12-0022-03 　　Clinical effect of bilateral craniotomy in treatment of severe traumatic brain injury 　　ZHU Huiwen LU Haiqin 　　Department of General Surgery， the Central Hospital of Zibo City in Shandong Province， Zibo 255031， China 　　[Abstract] Objective To investigate the effect of craniotomy bilateral in treatment of severe traumatic brain injury. Methods Selected 50 patients underwent bilateral craniotomy in treatment of severe brain trauma as research subjects， recorded intracranial pressure changes at the first 1 d， the first 3 d， 7 d after operation， and the follow-up after 6 months， the body recovery scores were compared. Results The intracranial pressure in patients was on a downward trend postoperative 1 d， 3 d， 7 d. Three patients died， accounting for 6.00%； Good recovery in 24 cases， accounting for 48.00%； Moderate disability in 16 cases， accounting for 32.00%； Six cases of severe disability， accounting for 12.00%， in a vegetative state in one case， accounting for 2.00%. Conclusion The bilateral craniotomy should be used early on severe traumatic brain injury patients with bilateral craniotomy indications， it can effectively improve the treatment effect， reduce morbidity and mortality， treatment of severe traumatic brain injury is an effective method， but need to strictly control surgical indications and perioperative good job. 　　[Key words] Bilateral craniotomy； Severe traumatic brain injury； Clinical effect 　　颅脑损伤是外科的常见病、多发病，尤其重型颅脑损伤的致残率和病死率均较高。手术是治疗颅脑损伤的常用方法，其中双侧开颅术是治疗重型颅脑损伤最常见的方法，对于提高抢救成功率具有重要作用[1]。但在采取双侧开颅手术治疗的过程中，由于手术创伤较大、时间较长、手术风险性较大，