改良大骨瓣减压术中渐进性减压治疗重型颅脑损伤的疗效分析

目的探讨改良大骨瓣减压术中渐进性减压治疗重型颅脑损伤（sTBI）患者的疗效。 方法选取保定市第一中心医院神经外二科自2015年10月至2017年12月收治的sTBI患者70例,均行改良大骨瓣减压术,按照简单随机抽样方法分为观察组和对照组,对照组35例行常规减压,观察组35例行渐进性减压。比较2组患者术后神经功能恢复及并发症发生情况。 结果2组患者术前GCS评分比较差异无统计学意义（P>0.05）。观察组患者术后1 d、7 d、1个月的GCS评分均高于对照组,术后并发症发生率均低于对照组,差异有统计学意义（P<0.05）。2组患者的中、重度残疾及植物生存发生率比较,差异无统计学意义（P>0.05）。观察组患者术后GOS评分均显著高于对照组,术后死亡率明显低于对照组,差异有统计学意义（P<0.05）。 结论对sTBI患者行改良大骨瓣减压术中渐进性减压有利于促进患者受损神经功能恢复、降低手术并发症、改善预后。

Effect of progressive decompression for severe traumatic brain injury during modified large bone flap decompression

ObjectiveTo investigate the effect of progressive decompression in the treatment of severe traumatic brain injury (sTBI) with modified large bone flap decompression. MethodsSeventy patients with sTBI admitted to our hospital from October 2015 to December 2017 were randomly divided into the observation group and the control group by modified large bone flap decompression. The control group (35 cases) received routine decompression and the observation group (35 cases) received progressive decompression. The postoperative neurological function recovery and complications of the two groups were compared. ResultsThere was no significant difference in preoperative GCS scores between the two groups (P>0.05). The GCS score of the patients in the observation group was higher than that in the control group 1 d, 7 d and 1 month after operation, and the incidence of complications was lower than that in the control group (P<0.05). There was no significant difference in the incidence of moderate disability, severe disability and plant survival between the two groups (P>0.05). The GOS score of the observation group was significantly higher than that of the control group, and the mortality rate was significantly lower than that of the control group (P<0.05). ConclusionProgressive decompression during modified large bone flap decompression in patients with sTBI can promote the recovery of injured nerve function, reduce surgical complications and improve prognosis.