重型脑外伤行开颅手术中发生急性脑膨出临床处理分析.docVIP

重型脑外伤行开颅手术中发生急性脑膨出临床处理分析 　　[摘要] 目的 探讨重型脑外伤行开颅手术中发生急性脑膨出的原因及相应的临床处理方法和效果。 方法 回顾性分析本院2005年12月～2014年12月收治的49例重型脑外伤行开颅手术中发生急性脑膨出患者的临床资料，按照处理方法分为对照组（脑组织切除减压法，24例）和观察组（功能性和介入减压法，25例）。观察两组的死亡情况和死亡患者术后存活天数等，并进行比较。 结果 对照组和观察组的死亡率分别为83.33%（20/24）和48.00%（12/25），观察组显著低于对照组（P0.05）；在死亡患者术后存活天数方面，观察组和对照组分别为（6.35±0.58）d和（1.52±0.35）d，观察组显著长于对照组（P0.05）。 结论 对重型脑外伤行开颅手术中发生急性脑膨出的患者，实施功能性和介入减压法处理可以获得更好的临床效果。 　　[关键词] 重型脑外伤；开颅手术；急性脑膨出；临床处理 　　[中图分类号] R651.1 [文献标识码] B [文章编号] 1673-9701（2015）16-0024-03 　　[Abstract] Objective To explore the reason and the corresponding clinical treatment methods and effects of acute cerebral swelling occurred in severe traumatic brain injury underwent craniotomy operation. Methods A retrospective analysis was performed on clinical data of patients with acute encephalocele occurred in 49 cases of severe traumatic brain injury underwent craniotomy operation in our hospital from December 2005 to December 2014，and they were divided into the control group （brain tissue resection and decompression， 24 cases） and the observation group （functional and interventional decompression，25 cases） according to processing method. Death and the death of patients with postoperative survival time of the two groups were observed and compared. Results Mortality of the control group and the observation group were 83.33% （20/24） and 48% （12/25） respectively， the observation group was significantly lower than the control group（P0.05）； the survival time of death after operation of the observation group and the control group respectively were （6.35±0.58） d and （1.52±0.35） d， the observation group was significantly longer than control group（P0.05）. Conclusion It can get better clinical effect of implementation of functional and interventional treatment of decompression method on patient with acute cerebral swelling occurred in severe traumatic brain injury underwent craniotomy operation. 　　[Key words] Severe traumatic brain injury；Craniotomy operation；Acute encephalocele；Clinical tr