改良去骨瓣减压术治疗重型颅脑损伤临床研究.docVIP

改良去骨瓣减压术治疗重型颅脑损伤临床研究 　　[摘要] 目的 探讨重型颅脑损伤患者采取改良去骨瓣减压术的疗效。方法 随机选取200例于2010年5月―2015年5月期间该院接收的重度颅脑损伤患者，将其按手术方式的不同分为对照组与实验组，两组分别采用标准外伤大骨瓣减压术和改良去骨瓣减压术，观察两组疗效。结果 术后2周，实验组GCS评分为（12.31±2.34）分，对照组为（9.51±1.32）分，实验组GCS评分较对照组明显要高（P0.05）；同时治疗后实验组恢复良好率为51.0%、死亡率5.0%、重度残疾8%、轻度残疾29%、植物生存7.0%，而对照组分别为32.0%、14.0%、25.0%、10%、19.0%，实验组预后明显优于对照组（P0.05）；另外实验组术后20例（20.0%）发生并发症，而对照组共39例（39.0%）发生并发症，差异有统计学意义（P0.05）。 结论 对重度颅脑损伤患者采取改良大骨瓣减压术，疗效显著，值得推广。 　　[关键词] 重型颅脑损伤；改良去骨板减压术；疗效 　　[中图分类号] R651.15 [文献标识码] A [文章编号] 1674-0742（2015）10（a）-0011-03 　　Clinical Study of Improved Decompressive Craniotomy in the Treatment of Severe Craniocerebral Injury 　　LI Qin-pu， ZHANG Min 　　Department of Neurosurgery， Tonghua Central Hospital， Tonghua， Jilin Province， 134000 China 　　[Abstract] Objective To study the curative effect of improved decompressive craniotomy in the treatment of severe craniocerebral injury. Methods 200 patients with severe craniocerebral injury treated in our hospital from May 2010 to May 2015 were selected and divided into control group and experimental group according to different operation schemes. Two groups respectively adopted the standard large trauma craniotomy and improved decompressive craniotomy. The curative effect of the two groups was observed. Results Two weeks after surgery， the GCS of the experimental was significantly higher than that of the control group [（12.31±2.34）points vs （9.51±1.32） points]（P0.05）； at the same time， rate of good recovery， mortality， severe disability， mild disability， and persistent vegetative status was 51.0%， 5.0%， 8%， 29%， 7.0% respectively in the experimental group and 32.0%， 14.0%， 25.0%， 10% and 19.0% respectively in the control group， which showed that the prognosis was significantly better in the experimental group than in the control group with statistical difference （P0.05）. In addition， the complication rate was 20.0% （20 cases） in the experimental group and 39.0% （39 cases） in the control group， and the difference was statistically s