双侧开颅去骨瓣减压术治疗对冲性重型颅脑损伤的疗效.docVIP

精品论文 参考文献 双侧开颅去骨瓣减压术治疗对冲性重型颅脑损伤的疗效 江苏省南京市六合区人民医院神经外科 邮编：211500 　　【摘要】 目的：探究对冲性重型颅脑损伤（STBI）患者应用双侧开颅去骨瓣减压术的临床疗效。方法：对我院2015年1月-2016年1月收治的80例对冲性STBI患者进行观察，采用随机分组法分为研究组和参照组，研究组行双侧开颅去骨瓣减压术，参照组行单侧开颅去骨瓣减压术。随访半年，观察两组患者治疗效果。结果：研究组中重度残疾率、死亡率、并发症发生率明显低于参照组（P＜0.05）；研究组恢复良好的患者明显多于参照组（P＜0.05）。结论：双侧开颅去大骨瓣减压术可以迅速、安全地降低颅内压和脑容量，降低对冲性STBI残死率。 　　【关键词】对冲性STBI；开颅去骨瓣减压术；临床疗效 　　The curative effect on hedging severe craniocerebral injury treated with bilateral bone flap decompressive craniectomy 　　【Abstract】 Objective: To explore the clinical curative effect on hedging severe traumatic brain injury (STBI) treated with bilateral bone flap decompressive craniectomy. Methods: From January in 2015 to January in 2016 in our hospital, 80 cases of patients with hedging STBI were observed, and divided into research group and control group by random grouping method. The research group was given bilateral bone flap decompressive craniectomy, and the control group was given unilateral bone flap decompressive craniectomy Followed up for six months, the effects of patients in the two groups were observed. Results: The severe disability rates, mortality and complication rates of the research group were significantly lower than the control group (P lt; 0.05); The patients recovering well of the research group were significantly more than the control group (P lt; 0.05). Conclusion: The bilateral bone flap decompressive craniectomy can reduce the intracranial pressure and brain capacity quickly and safely, and reduce the death rate of hedging STBI. 　　【Keywords】 Hedging STBI; Bone flap decompressive craniectomy; Clinical curative effect 　　对冲性STBI常合并有多处颅骨骨折、脑挫裂伤，主要见于交通事故、生产事故、坠落等，病情危重，死残率极高[1]。患者昏迷时间超过6 h，有头痛、癫痫、恶心、偏瘫、意识障碍、反复昏迷等表现。脑组织损伤后脑部会生成大量氧自由基，出现恶性颅内压升高，增加了死亡风险[2]。有效的降低颅内压措施对对冲性STBI至关重要，双侧开颅去骨瓣减压术直接清除颅内异物，去除骨瓣，修复受损颅内组织进行修复，扩大颅内容积、降低颅内压，减少外力对脑干的压迫，降低残死率[1]，在临床应用中得到了广大患者和医生的青睐。 　　1 资料与方法 　　1.1一般资料 　　观察对象为我院2015年1月-2016年1月收治的80例对冲性STBI患者，所有患者经颅脑CT、MRI检查明确诊断，签署知情同意书。其中男49例，女31例，年龄为22-66岁，中位年龄为39.0岁。采用随机分组法将