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(P<0.05);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(P<0.05);观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。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。
Objective To evaluate the clinical efficacy and complications of sequential bilateral decompressive craniectomy and predictive bilateral decompressive craniectomy for serious craniocerebral trauma. Methods 80 cases of serious craniocerebral trauma treated byneurosurgery Department of Jinhua Traditional Chinese Medicine Hospital from December 2010 to December 2016 were collected and divided into two groups named control group and observation group of 40 cases according to the admission order. The control group was treated with sequential bilateral decompressive craniectomy treatment, and the observationgroup was treated with predictive bilateral decompressive craniectomy treatment. The intracranial pressure( ICP),Glasgow outcome score( GOS),death and postoperative complications of two groups in 24,48 and 72 hours after surgery were observed. Results The ICP of two groups were significantly decreased after surgery, and there were significant difference between two groups ICP in 24,48 and 72 h after surgery,in addition the observation group were higher than the control group( P< 0. 05); after following up for 3 months,the GOS of observation group was higher than the control group,the mortality rate and complication rate were lower than group control,in addition besides the difference were statistically significant( P < 0. 05).Conclusion Compared with sequential bilateral decompressive craniectomy,predictive bilateral decompressive craniectomy can effectively reduce the ICP, mortality rate and complication rate, and promote prognosis, otherwise the clinical efficacy is remarkable.
出处
《中国全科医学》
CAS
北大核心
2017年第A01期98-100,共3页
Chinese General Practice
关键词
颅脑损伤
减压术
外科
治疗结果
Craniocerebral trauma
Decompression
surgical
Treatment outcome
