相继性双侧去骨瓣减压术与预见性双侧去骨瓣减压术治疗重度颅脑损伤的临床疗效

发布时间：2018-05-11 14:55

本文选题：颅脑损伤 + 减压术　；参考：《中国全科医学》2017年S1期

【摘要】：目的探讨相继性双侧去骨瓣减压术与预见性双侧去骨瓣减压术治疗重度颅脑损伤的临床疗效和并发症情况。方法选取金华市中医医院2010年12月—2016年12月神经外科收治80例重度颅脑损伤患者为研究对象,根据入院顺序将其分为对照组和观察组各40例,对照组采用相继性双侧去骨瓣减压术治疗,观察组采用预见性双侧去骨瓣减压术组治疗,观察患者术后24、48、72 h的颅内压、格拉斯哥预后评分(GOS)、死亡情况及两组术后并发症。结果两组术后颅内压均明显下降,观察组术后24、48、72 h颅内压均高于对照组,差异有统计学意义(P0.05);术后随访3个月,观察组GOS评分恢复良好率高于对照组,死亡率低于对照组,差异有统计学意义(P0.05);观察组并发症发生率低于对照组,差异有统计学意义(P0.05)。结论和相继性双侧去骨瓣减压术治疗重度颅脑损伤患者相比,预见性双侧去骨瓣减压术能有效降低患者颅内压和促进预后恢复,降低患者死亡风险和手术并发症发生率,临床疗效显著。
[Abstract]:Objective to investigate the clinical efficacy and complications of sequential bilateral bone flap decompression and predictive bilateral bone flap decompression in the treatment of severe craniocerebral injury. Methods from December 2010 to December 2016, 80 patients with severe craniocerebral injury in Jinhua Hospital of traditional Chinese Medicine were selected and divided into control group (n = 40) and observation group (n = 40). The patients in the control group were treated with sequentially bilateral bone flap decompression, and the patients in the observation group were treated with prescient bilateral bone flap decompression. The intracranial pressure (ICP), Glasgow prognosis score (Glasgow prognosis score) and postoperative complications were observed at 24872 hours after operation. Results Intracranial pressure (ICP) in the observation group was significantly lower than that in the control group at 24: 472 h after operation, and the difference was statistically significant (P 0.05), and the recovery rate of GOS score in the observation group was higher than that in the control group, and the mortality was lower than that in the control group after 3 months follow-up. The incidence of complications in the observation group was lower than that in the control group (P 0.05). Conclusion compared with sequential bilateral bone flap decompression in the treatment of severe craniocerebral injury, the prescient bilateral decompression can effectively reduce the intracranial pressure and promote the recovery of prognosis, reduce the risk of death and the incidence of complications. The clinical effect is remarkable.
【作者单位】：浙江省金华市中医医院;
【分类号】：R651.15

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