重症颅脑损伤大骨瓣减压术治疗的效果观察(1)
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【摘要】 目的 观察与分析重症颅脑损伤的手术治疗效果，以期提高临床疗效，促进患者神经功能恢复。
方法 将60例重症颅脑损伤者随机分为两组，对照组30例，采取传统去骨瓣减压术，实验组30例，给予大骨瓣减压术，观察两组术后日常生活能力分级和手术并发症发生率。结果 实验组的日常生活能力分级评估预后显著好于对照组(P<0.05)，手术并发症发生率显著低于对照组(P<0.01)。结论 大骨瓣减压术治疗重症颅脑损伤的临床效果显著。
【关键词】 重症颅脑损伤；大骨瓣减压术；去骨瓣减压术
文章编号：1003-1383(2011)06-0708-03 中图分类号：R 651.1+5 文献标识码：A
doi:10.3969/j.issn.1003-1383.2011.06.008
Observation of the effect of craniotomy to treat severe traumatic brain injury
ZHANG Jiyuan
(Qinzhou First People's Hospital,Qinzhou,Guangzhou 535000)
【Abstract】 Objective To observe and analyze the surgical treatment of severe traumatic brain injury in order to improve the clinical efficacy and to promote the recovery of neurological function.
Methods Sixty patients with severe traumatic brain injury were divided into two groups (n=30) and given appropriate surgical treatment. The control group were treated by traditional decompressive craniectomy while the experimental group were treated by large decompressive craniotomy. Daily living activities and surgical complications of both groups after surgery were observed.
Results The evaluation of daily living ability grading for the experimental group was obviously better than that of the control group(P<0.05).The postoperative complication rate of the experimental group was significantly lower than that of the control group(P<0.01).
Conclusion The effect of large decompressive craniotomy for treating severe traumatic brain injury is obvious.
【Key words】 severe traumatic brain injury；large depressive craniotomy；decompressive craniectomy
随着社会发展及人们生活空间的加大，交通事故、高空坠落和各种施工事故等因素所导致的重症颅脑损伤发生率逐年升高，该病常造成脑挫裂伤、颅内血肿、脑水肿和弥漫性轴索损伤等[1]，对患者生命安全构成极大威胁且处理颇为棘手。我们对重症颅脑损伤者给予不同手术治疗方法，以期提高手术治疗效果、促进患者更好的康复，现将观察结果报道如下。
资料与方法
1.一般资料 选取2009年10月～2011年2月在我院住院治疗的重症颅脑损伤患者60例，男43例，女17例，年龄13～68岁，平均(37.00±1.00)岁；Glasgow评分：6～8分者19例占31.67%，3～5分者41例占68.33%；中线结构发生移位：5～10 mm者43例，11～15 mm者17例。按照随机数字表法将60例患者随机分为两组。实验组30例，男21例，女9例，平均年龄(36.90±1.00)岁，Glasgow评分：6～8分10例，3～5分20例；中线结构发生移位：5～10 mm者21例，10～15 mm者9例。对照组30例，男22例，女8例，平均年龄(37.10±1.00)岁，Glasgow评分：6～8分9例，3～5分21例；中线结构发生移位：5～10 mm者22例，10～15 mm者8例。两组性别、年龄及中线结构移位等一般资料比较差异无统计学意义(P<0.05),具有可比性。
2.入选和排除标准 符合《现代颅脑损伤学》[2]中重症颅脑损伤诊断标准,并经CT或MRI得以确诊 ......
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