双侧开颅治疗外伤性颅内多发性血肿临床体会.docVIP

双侧开颅治疗外伤性颅内多发性血肿临床体会 　　【摘要】 目的 探讨外伤性颅内多发性血肿外科手术治疗的临床体会。方法 68例外伤性颅内多发性血肿患者， 随机分为对照组与观察组， 每组34例。对照组行分期双侧开颅手术治疗， 观察组行一期双侧开颅手术治疗。对比两组疗效和预后。结果 观察组治疗良好率、重度残疾率、死亡率分别为79.4%、17.6%、2.9%， 对照组分别为47.1%、38.2%、14.7%， 观察组治疗效果优于对照组（P0.05）。治疗后观察组格拉斯哥预后评分（GOS）与对照组比较差异有统计学意义（P0.05）。结论 一期双侧开颅手术方案较分期双侧开颅手术方案治疗外伤性颅内多发性血肿的效果更优， 患者预后良好， 致残致死率低， 值得推广应用。 　　【关键词】 颅内血肿；外伤；双侧开颅 　　DOI：10.14163/j.cnki.11-5547/r.2016.07.005 　　Clinical experience of bilateral craniotomy in the treatment of traumatic multiple intracranial hematoma QIU Nai-xi. Department of Craniocerebral， Haifeng County Pengpai Memorial Hospital， Shanwei 516400， China 　　【Abstract】 Objective To investigate clinical experience of surgical treatment for traumatic multiple intracranial hematoma. Methods A total of 68 patients with traumatic multiple intracranial hematoma were randomly divided into control group and observation group， with 34 cases in each group. The control group received staging bilateral craniotomy， and the observation group received one time bilateral craniotomy. Curative effect and prognosis of the two groups were compared. Results The observation group had good rate， severe disability rate， and mortality rate as 79.4%， 17.6% and 2.9%， and they were 47.1%， 38.2% and 14.7% in the control group. The observation group showed better curative effect than the control group （P0.05）. The difference of Glasgow outcome score （GOS） scores after treatment between the observation group and the control group had statistical significance （P0.05）. Conclusion One time bilateral craniotomy provides better effect in treating traumatic multiple intracranial hematoma than staging bilateral craniotomy. This method shows good prognosis and low mortality， and it is worth promoting and applying. 　　【Key words】 Intracranial hematoma； Trauma； Bilateral craniotomy 　　重度颅脑损伤导致颅内出现超过2个不同类型或者部位的血肿即称之为多发性颅内血肿， 此类患者大多合并严重脑部挫裂伤， 病情紧急危重， 具有较高的病死率与致残率， 预后相对较差[1]。本文探讨外伤性颅内多发性血肿外科手术治疗的临床体会。现报告如下。 　　1 资料与方法 　　1. 1 一般资料 选取2010年6月～2015年6月本院68例外伤性颅内多