摘要
目的:研究并探讨双侧去骨瓣减压术治疗急性颅脑损伤的临床效果及降低患者颅内压的作用。方法:选择2011年1月-2016年12月本院接收的90例急性颅脑损伤患者为研究对象,按照随机数字表法将患者分为对照组和观察组,各45例。对照组采用单侧去骨瓣减压术治疗,观察组采用双侧去骨瓣减压术治疗。比较两组患者的手术时间、术中出血量、术后并发症发生率、颅内压、神经功能缺损评分、生存质量评分、预后情况。结果:两组术中出血量比较,差异无统计学意义(P>0.05)。观察组手术时间长于对照组(P<0.05)。观察组的术后并发症发生率为4.44%,低于对照组的20.00%,差异有统计学意义(P<0.05)。两组术后颅内压均较术前显著降低(P<0.05),且术后观察组的颅内压低于对照组(P<0.05)。两组术后神经功能缺损评分均较术前显著降低(P<0.05),且术后观察组的神经功能缺损评分低于对照组(P<0.05)。术后随访6个月,在生理机能、生理职能、躯体疼痛、活力、社会职能、情绪职能、精神健康、总体健康等方面,观察组的生存质量评分均高于对照组(P<0.05),且观察组的预后良好率高于对照组(P<0.05)。结论:采用双侧去骨瓣减压术对急性颅脑损伤患者进行治疗,虽然会延长手术时间,但该术式可在不增加术中出血量的前提下,尽可能降低患者颅内压,促使患者神经功有效改善,有利于改善患者术后生存质量及预后状况。
Objective：To study the clinical effect of bilateral bone flap decompression in the treatment of acute craniocerebral injury and the effect of reducing intracranial pressure.Method：90 patients with acute craniocerebral injury from January 2011 to December 2016 in our hospital were selected as the research objects,patients were randomly divided into control group and observation group,according to the method of random digital table.The control group was treated with unilateral bone flap decompression,and the observation group was treated with bilateral bone flap decompression.The time of operation,the amount of blood lost during operation,the incidence of postoperative complications,intracranial pressure,neurological deficit score,quality of life score and prognosis were compared between the two groups.Result：There was no significant difference in intraoperative blood loss between the two groups（P〈0.05）.The operative time in the observation group was longer than that in the control group（P〈0.05）.The incidence of postoperative complications in the observation group was 4.44%,which was lower than 20.00% in the control group,the difference was statistically significant（P〈0.05）.Intracranial pressure in the two groups were significantly lower than those before operation（P〉0.05）,after operation,the intracranial pressure in the observation group was lower than that in the control group（P〈0.05）.The neurological deficit score in the two groups were significantly lower than those before operation（P〈0.05）,after operation,the neurological deficit score in observation group was lower than that in the control group（P〈0.05）.After 6 months follow-up,the scores of quality of life in the observation group were higher than those in the control group in the aspects of physical function,physical role function,somatic pain,vitality,social function,emotional function,mental health and overall health（P〈0.05）.The rate of good prognosis in the observation group was higher than that in the control group（P〈0.05）.Conclusion：Bilateral decompression of bone flap is used to treat the patients with acute craniocerebral injury,although the operation time will be prolonged,the operation method can reduce the intracranial pressure as much as possible without increasing the amount of intraoperative bleeding,and promote the effective improvement of the patients＇ neurological work,it is beneficial to improve the quality of life and prognosis of patients after operation.
作者
韦骋
陆明雄
WEI Cheng;LU Mingxiong(Baise People＇s Hospital,Baise 533000,China)
出处
《中国医学创新》
CAS
2018年第23期27-30,共4页
Medical Innovation of China
关键词
急性颅脑损伤
双侧去骨瓣减压术
单侧去骨瓣减压术
颅内压
Acute craniocerebral injm7
Bilateral bone flap decompression
Unilateral bone flap decompression
Intracranial pressure
