标准外伤大骨瓣开颅术治疗广泛脑挫裂伤并大面积脑梗死临床研究.docVIP

标准外伤大骨瓣开颅术治疗广泛脑挫裂伤并大面积脑梗死临床研究 　　[摘要] 目的 探讨标准外伤大骨瓣开颅术（SLTC）治疗广泛脑挫裂伤并大面积脑梗死的临床效果。 方法 67例广泛脑挫裂伤并大面积脑梗死患者随机分为治疗组和对照组，治疗组给予SLTC治疗，对照组给予常规骨瓣开颅术治疗，术后评价颅内压降低情况和并发症发生情况、随访6个月评价临床疗效。结果 术后两组颅内压均明显下降，且术后1、3、7d治疗组颅内压显著低于对照组（P＜0.05）；治疗组有效率为61.8%，显著高于对照组的 15.2% ；治疗组重残、植物状态和死亡发生率均显著低于对照组（P＜0.05）；两组术后并发症发生率差异无统计学意义（P＞0.05）。 结论 SLTC治疗广泛脑挫裂伤并大面积脑梗死可以显著降低患者颅内压，提高治疗效果和减少死亡，值得临床应用。 　　[关键词] 广泛脑挫裂伤；大面积脑梗死；标准外伤大骨瓣开颅术；常规骨瓣开颅术 　　[中图分类号] R651.1+5 [文献标识码] B [文章编号]1673-9701（2011）24-51-03 　　 　　The Effect of Standard Large Trauma Craniotomy in Treatment of Extensive Brain Contusion Combined with Massive Cerebral infarction：A Clinical Resercher 　　CHEN Yongpeng CHEN Xianglin TAO Xumin MAO Zhenmin 　　Department of Brain Science Center， Qingyuan Municipal People’s Hospital，Qingyuan 511500，China 　　[Abstract] Objective To investigate the effect of standard large trauma craniotomy in treatment of extensive brain contusion combined with massive cerebral infraction. Methods Sixty-sever patients with brain contusion were assigned randomly into treatment group in which the SLTC was used， and control group in which the routine temporoparietal craniectomy was used. After surgery， intracranial pressure and occurrence rate of complications was also measured. Furthermore， a 6-month-post surgery follow up observation was also conducted. Results The intracranial pressure of both groups were decreased significantly after treatment，while in both 1，3，5 and 7 days post-surgery the effect of SLTC was better than traditional method. The effectiveness of SLTC was 61.8%， which rate was significantly higher than control group （15.2%）. The side effects and failure rate of SLTC was lower than control group， while the complication occurrence after surgery was the same statistically. Conclusion SLTC could effectively decrease intracranial pressure and death rate after surgery， and is a valuable surgical way for clinical practice. 　　[Key words] Extensive brain contusion； Massive cerebral infraction； Standard large traum