标准大骨瓣减压术治疗重型颅脑损伤30例疗效分析.docVIP

标准大骨瓣减压术治疗重型颅脑损伤30例疗效分析 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：标准大骨瓣减压术治疗重型颅脑损伤30例疗效分析 1 1 资料与方法 2 2 结果 4 3 讨论 4 文2：去大骨瓣减压术治疗重型颅脑损伤疗效分析 5 参考文摘引言： 7 原创性声明（模板） 8 文章致谢（模板） 8 正文 标准大骨瓣减压术治疗重型颅脑损伤30例疗效分析 文1：标准大骨瓣减压术治疗重型颅脑损伤30例疗效分析 [Abstract] Objective To explore the curative effect of standard large trauma craniotomy in the treatment of severe craniocerebral The patients with severe craniocerebral injury who were hospitalized in our department were randomly divided into 2 groups： the treatment group was operated standard large trauma craniotomy(n=30)，the control group with routine craniectomy(the control group，n=16).Following up the patients，the conditio of postoperative recovery were recorded，the rate of good and mortality were compared，the data were The good rate of the group of standard large trauma craniotomy was higher than the group of patients with routine craniectomy，the mortality rate was lower than the control group，there were significant differences between the rate of two groups(χ2=，P，χ2=，P).Conclusion Standard large trauma craniotomy has the characteristic： sufficient exposure，thorough decompression，effective protection of cerebral function，and can significantly improved prognosis and reduced case fatality，and the operation should be introduced exteively. [Key words] standard large trauma craniotomy;severe craniocerebral injury 重型颅脑损伤是神经外科常见急诊，往往合并脑挫裂伤、脑水肿、恶性颅内压增高导致患者死亡或致残。标准外伤大骨瓣减压术(standard large trauma craniotomy)在临床已应用广泛，是治疗重型颅脑损伤的重要术式。我科自2003年至2009年5月以来采用美国标准外伤大骨瓣减压术治疗重型颅脑损伤30例，获得较满意效果，现报告如下。 1 资料与方法 一般资料 将患者分为两组：(1)标准大骨瓣减压术组(治疗组)：患者30例，男22例，女8例，年龄12～65岁，平均(±)岁;受伤原因：车祸18例，打击伤8例，坠落伤4例;受伤部位：后枕部4例，顶枕部16例，额顶颞部10例;入院时均有不同程度的意识障碍，格拉斯哥评分(GCS评分)：3～5分6例，6～8分18例，8分8例。单侧瞳孔散大16例，双侧瞳孔散大4例，无瞳孔变化10例。CT表现：颞部或颞顶部急性硬脑膜外血肿8例，额颞顶急性硬脑膜下血肿12例，其中合并额颞脑挫裂伤7例，脑内血肿3例。中线结构移位均10 mm，环池、基底池受压16例，消失3例。(2)常规骨瓣开颅术组(对照组)：患者16例，男12例，女4例，年龄14～68岁，平均(±)岁，单侧瞳孔散大9例，双侧瞳孔散大2例，无瞳孔变化5例;入院时均有不同程度意识障碍，GCS评分3～5分3例，6～8分8例，8分5例。两组患者年龄、性别、GCS评分及颅脑CT等方面经统计学处理，差异无统计学意义(P)，具有可比性