改良标准外伤大骨瓣开颅术治疗重型颅脑外伤临床观察.pdfVIP

口固言群裟刚眦眦T。晰删． 论 著 改良标准外伤大骨瓣开颅术治疗重型颅脑外伤临床 观察 马骏峰 复旦大学附属上海市第五人民医院．上海200240 【摘要】目的观察改良标准外伤大骨瓣开颅术治疗重型颅脑外伤的手术效果。方法将56例重型颅脑损伤患者，根据手术 方法不同分为改良组和对照组各28例。对照组采用常规去骨瓣减压术。改良组采用改良标准外伤大骨瓣开颅术。结果改 评分为明显高于对照组，差异有统计学意义(P0，05)。干预组发生术后再出血、切口疝、癫痫例数分别为4例，l例，l例，对 照组发生脑肿胀3例，颅内感染1例，癫痫2例，切口疝8例，术后再出血8例，两组均无一例发生脑脊液切口漏。结论改 良标准外伤大骨瓣开颅术治疗重型颅脑外伤疗效确切，并发症少，能明显改善患者的预后，值得推广和应用。 【关键词】重型颅脑损伤；标准大骨瓣减压术；改良标准外伤大骨瓣开颅术 【中图分类号】R651．1 【文献标识码】A [文章编号】1674一0742(2012)10(a)一0006—02 StandardTrauma TreatmentofSeVere ImproVed Iarge Craniotomy￡Dr TraumaticBrain Clinicalobservation Injury MA Ju氇砖ng Fudan Fifth 200240，China University，ShanghaiPeople’sHospital，Shanghai of Toobsenrethe standardtrauma treatmentseveretraumaticbmin [Abstract】objective improved large craniotomysurgical efkcts．Methods56casesofseveretmumaticbmin tothedifferent methodsaredivided injury injurypatients，accordingsurgical intothemodi6edandcontrol of28caseseach．Contml conventional gmup gmup gmupusing decompressivecmniectomy．The modified standardtrauma Results total was gmupi哪pmved la。ge craniotomy． ImpmvedpostoperatiVeemciencysignificantly was lowerthanthecontrol difkrencewas higher，mortalitysignificantly group，the statisticallysignificant(P0．05)．Impmved was withthe GCS GCSscore (14．25±2．92)，(7．64±2．52)comparedpreoperativesignificantlyhigherpostoperative ．posto