改良大骨瓣联合软通道微创介入逐渐减压术治疗重型颅脑损伤疗效分析.docVIP

改良大骨瓣联合软通道微创介入逐渐减压术治疗重型颅脑损伤疗效分析 　　[摘要] 目的 探讨改良大骨瓣联合软通道微创介入逐渐减压术治疗重型颅脑损伤的疗效。方法 方便选择自2009年12月―2014年11月该院收治的重型颅脑损伤病例70例，随机分为改良组和对照组2组，每组35例，改良组施行改良大骨瓣联合软通道微创介入逐渐减压术，对照组按标准大骨瓣开颅、硬脑膜一次性全切开，对比分析两组的并发症发生率及预后。结果 改良组发生迟发性颅内血肿、大面积脑梗塞及弥漫性脑肿胀等并发症9例（25.7%，9/35），预后良好者23例（65.7%，23/35），对照组发生并发症19例（54.3%，19/35），预后良好者14例（40.0%，14/35），两组并发症发生率和预后差异具有统计学意义（P0.05）。结论 改良大骨瓣联合软通道微创介入逐渐减压术治疗重型颅脑损伤，效果良好，显著降低死亡率。 　　[关键词] 改良大骨瓣；软通道微创介入；逐渐减压 　　[中图分类号] R651.15 [文献标识码] A [文章编号] 1674-0742（2016）08（b）-0064-03 　　[Abstract] Objective To explore the curative effect of the improved joint soft channel of minimally invasive interventional gradually craniotomy decompression for the treatment on the patients with severe craniocerebral injury. Methods Convenient seventy patients with severe craniocerebral injury，who were treated from December 2009 to November 2014， were randomly divided into treatment group（35cases） and control group（35cases）， the improved joint soft channel of minimally invasive interventional gradually craniotomy decompression was performed in the treatment group， the patients in the control group received the standard large trauma craniotomy with dura cut at once. The incidence of complications and the prognosis were analyzed in the all patients. Results The incidence of complications（25.7%，9/35） was significantly smaller in the treatment group than that（54.3%，19/35） in the control group（P0.05），the prognosis（65.7%，23/35） was better in the treatment group than that（40.0%，14/35） in the control group（P0.05）. Conclusion The curative effect of the improved joint soft channel of minimally invasive interventional gradually craniotomy decompression is significantly better than that in the control group，the mortality rate was rapidly reduced。 　　[Key words] Improved large craniotomy；The soft channel of minimally invasive interventional；Gradually decompression 　　1 资料与方法 　　1.1 一般资料 　　研究对象为方便选取该院神经外科自2009年12月―2014年11月收治的重型颅脑损伤病例70例，均满足适应症：GCS评分3～7分，中线结构移位?1.0 cm。将研究对象随机分为改良组和对照组两组，每组35例。改良组：