标准外伤大骨瓣开颅减压术治疗重型颅脑损伤的有效性探究

目的：探讨标准外伤大骨瓣开颅减压术在临床救治重型颅脑损伤患者中的应用价值。方法将2008年6月-2013年6月我院收治的89例重型颅脑损伤患者按不同手术治疗方案随机分为对照组（42例，行常规骨瓣开颅减压术）和观察组（47例，行标准大骨瓣开颅减压术），对两组患者预后效果、术后 GCS 评分及并发症情况进行综合比较。结果①观察组患者预后良好率（63.83%）高于对照组（35.71%）（P ﹤0.01）；②术后7d，观察组患者GCS 评分为（9.76±1.14）分，高于对照组的（7.54±1.07）分（P ﹤0.01）；③观察组术后并发症发生率（14.89%）明显低于对照组（35.71%）（P ﹤0.05）。结论采用标准外伤大骨瓣开颅减压术治疗重型颅脑损伤疗效确切，能够明显改善患者预后。

Research on the effectiveness of standard large trauma craniotomy in the treatment of severe traumatic brain injury

Objective：To investigate the application of standard large trauma craniotomy in the clinical treatment of se-vere traumatic brain injury. Methods：Eighty-nine cases severe traumatic brain injury patients in our hospital from June 2008 to June 2013 were randomly divided into the control group（42 cases,were given routine large trauma craniotomy）and the observation group（47 cases,were given standard large trauma craniotomy）,the prognosis effect,postoperative GCS score and postoperative complications of two groups were comprehensively compared. Results：① The prognosis was better in the observation group（63. 83% ）than that in the control group（35. 71% ）（P ﹤ 0. 01）;② 7 days after operation,the GCS score of the observation group was 9. 76 ± 1. 14 ,while it was 7. 54 ± 1. 07 in the control group,and there was signifi-cant difference between the two groups（P ﹤ 0. 01）. ③ The incidence of postoperative complications in the observation group （14. 89% ）was lower than that in the control group（35. 71% ）（P ﹤ 0. 05）. Conclusion：Standard large trauma craniotomy has significant effects on treating severe traumatic brain injury.