标准大骨瓣开颅术治疗重型颅脑损伤的效果(1)
[摘要]目的 探讨标准大骨瓣开颅术治疗重型颅脑损伤的效果。方法 选取我院2015年12月～2017年11月收治的64例重型颅脑损伤患者，将其随机分为观察组和对照组，每组32例。对照组实施常规骨瓣开颅术治疗，观察组实施标准大骨瓣开颅术治疗。观察两组的手术效果、神经功能缺损程度评分。结果 治疗后，观察组的恢复良好率明显高于对照组，病死率明显低于对照组(P<0.05)。术后1个月，观察组的神经功能缺损评分显著低于对照组(P<0.05)。结论 标准大骨瓣开颅术在治疗重型颅脑损伤具有明显效果，可有效改善神经功能缺损，临床使用价值高。
[关键词]重型颅脑损伤；标准大骨瓣开颅术；临床效果
[中图分类号] R651.1+5 [文献标识码] A [文章编号] 1674-4721(2018)8(a)-0085-03
Effect of standard large bone flap craniotomy in the treatment of severe craniocerebral injury
WANG Ke1 WANG Ting2
1. Department of Neurosurgery， Ji′an Hospital of Shanghai Orient Hospital， Jiangxi Province， Ji′an 343000， China； 2. Community Health Service Center of Baitang Street in Jizhou District of Ji′an City， Jiangxi Province， Ji′an 343000， China
[Abstract] Objective To explore the effect of standard large bone flap craniotomy in the treatment of severe craniocerebral injury. Methods A total of 64 cases with severe craniocerebral injury treated in our hospital from December 2015 to November 2017 were selected and randomly divided into the observation group (n=32) and the control group (n=32). The control group was treated with routine bone flap craniotomy treatment， while the observation group was treated with standard large bone flap craniotomy. The operative effect and nerve function defect score between the two groups were observed. Results After treatment， the good recovery rate of the observation group was obviously higher than that of the control group， the fatality rate of the observation group was obviously lower than that of the control group (P<0.05).The nerve function defect score after 1 month operation in the observation group was significantly lower than that in the control group (P<0.05). Conclusion The standard large bone flap craniotomy in the treatment of severe head injury has obvious effect， which can effectively improve neurologic deficits， and its clinical use value is high.
[Key words] Severe craniocerebral injury； Standard large bone flap craniotomy； Clinical effect
顱脑损伤为临床较常见的一种疾病，通常由交通事故、施工事故及其他意外伤害而导致。重型颅脑损伤往往属于突发性疾病，而且病情凶险，其主要临床特点为昏迷时间较长、病情变化速度快、存在大量并发症、治疗存在一定难度、死亡率较高等，而颅内压异常上升、脑挫裂伤是导致患者死亡的主要因素，对患者生命安全造成为严重威胁。患者伤后较常见的临床症状如颅内血肿形成、 严重脑水肿、持续颅内高压均可能造成患者残疾、病死，所以应及时对其临床症状进行治疗，因此，在临床治疗时，需要及时快速地予以颅内降压、解除脑水肿、消除颅内血肿。常规骨瓣开颅术在治疗时难以充分暴露病灶，无法充分降压，导致临床效果不理想。近些年来，标准大骨瓣开颅术得到广泛应用，对于重型颅脑损伤具有明显效果，可提高预后[1]。本研究选取64例重型颅脑损伤患者，探讨标准大骨瓣开颅术治疗重型颅脑损伤的临床效果。
1资料与方法
1.1一般资料
选取我院2015年12月～2017年11月收治的64例重型颅脑损伤患者，患者均符合重型颅脑损伤的诊断标准，均签署知情同意书。本研究已经我院医学伦理委员会批准。将患者随机分为观察组和对照组，每组32例。观察组中，男22例，女10例；年龄21～64岁，平均(46.28±5.38)岁；致伤因素：车祸13例，摔伤15例，其他4例。对照组中，男23例，女9例；年龄31～64岁，平均(46.83±5.16)岁；致伤因素：车祸14例，摔伤14例，其他4例。两组患者的一般资料比较，差异无统计学意义(P>0.05)，具有可比性。, http://www.100md.com(王克 王婷)
[关键词]重型颅脑损伤；标准大骨瓣开颅术；临床效果
[中图分类号] R651.1+5 [文献标识码] A [文章编号] 1674-4721(2018)8(a)-0085-03
Effect of standard large bone flap craniotomy in the treatment of severe craniocerebral injury
WANG Ke1 WANG Ting2
1. Department of Neurosurgery， Ji′an Hospital of Shanghai Orient Hospital， Jiangxi Province， Ji′an 343000， China； 2. Community Health Service Center of Baitang Street in Jizhou District of Ji′an City， Jiangxi Province， Ji′an 343000， China
[Abstract] Objective To explore the effect of standard large bone flap craniotomy in the treatment of severe craniocerebral injury. Methods A total of 64 cases with severe craniocerebral injury treated in our hospital from December 2015 to November 2017 were selected and randomly divided into the observation group (n=32) and the control group (n=32). The control group was treated with routine bone flap craniotomy treatment， while the observation group was treated with standard large bone flap craniotomy. The operative effect and nerve function defect score between the two groups were observed. Results After treatment， the good recovery rate of the observation group was obviously higher than that of the control group， the fatality rate of the observation group was obviously lower than that of the control group (P<0.05).The nerve function defect score after 1 month operation in the observation group was significantly lower than that in the control group (P<0.05). Conclusion The standard large bone flap craniotomy in the treatment of severe head injury has obvious effect， which can effectively improve neurologic deficits， and its clinical use value is high.
[Key words] Severe craniocerebral injury； Standard large bone flap craniotomy； Clinical effect
顱脑损伤为临床较常见的一种疾病，通常由交通事故、施工事故及其他意外伤害而导致。重型颅脑损伤往往属于突发性疾病，而且病情凶险，其主要临床特点为昏迷时间较长、病情变化速度快、存在大量并发症、治疗存在一定难度、死亡率较高等，而颅内压异常上升、脑挫裂伤是导致患者死亡的主要因素，对患者生命安全造成为严重威胁。患者伤后较常见的临床症状如颅内血肿形成、 严重脑水肿、持续颅内高压均可能造成患者残疾、病死，所以应及时对其临床症状进行治疗，因此，在临床治疗时，需要及时快速地予以颅内降压、解除脑水肿、消除颅内血肿。常规骨瓣开颅术在治疗时难以充分暴露病灶，无法充分降压，导致临床效果不理想。近些年来，标准大骨瓣开颅术得到广泛应用，对于重型颅脑损伤具有明显效果，可提高预后[1]。本研究选取64例重型颅脑损伤患者，探讨标准大骨瓣开颅术治疗重型颅脑损伤的临床效果。
1资料与方法
1.1一般资料
选取我院2015年12月～2017年11月收治的64例重型颅脑损伤患者，患者均符合重型颅脑损伤的诊断标准，均签署知情同意书。本研究已经我院医学伦理委员会批准。将患者随机分为观察组和对照组，每组32例。观察组中，男22例，女10例；年龄21～64岁，平均(46.28±5.38)岁；致伤因素：车祸13例，摔伤15例，其他4例。对照组中，男23例，女9例；年龄31～64岁，平均(46.83±5.16)岁；致伤因素：车祸14例，摔伤14例，其他4例。两组患者的一般资料比较，差异无统计学意义(P>0.05)，具有可比性。, http://www.100md.com(王克 王婷)