改良外伤大骨瓣开颅减压术治疗特重型颅脑对冲伤临床研究

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1、改良外伤大骨瓣幵颅减压术治疗特重型颅脑对冲伤临床研究［摘要］目的研宄特重型颅脑对冲伤患者采用改良外伤大骨瓣开颅减压术治疗的临床效果。方法方便选取86例该院2013年9月一2015年9月期间收治的特重型颅脑对冲伤患者作为研究对象。按手术方式不同分为两组，其中43例患者采用标准大骨瓣开颅减压术治疗作为对照组，另43例患者采用改良外伤大骨瓣开颅减压术治疗作为观察组。观两组患者治疗后颅内压情况、预后情况以及并发症情况。结果两组术前颅内压水平差异无统计学意义；观察组术后1、3d颅内压水平明显低于对照组。观察组预后情况明显优于对照组。观察组、对照组并发症发生率分别为9.30%、27.9

2、1%，观察组明显较低。结论对于特重型颅脑对冲伤患者采用改良外伤大骨瓣开颅减压术治疗效果显著，有效降低了颅内压水平，改善患者预后情况，并发症少，安全性高，值得临床推广应用。［关键词］颅脑对冲伤；大骨瓣开颅减压术；改良外伤大骨瓣开颅减压术；临床疗效［中图分类号］R6［文献标识码］A［文章编号］1674-074205-0080-03[Abstract]ObjectiveTostudytheadoptionofModifiedTraumaLargeBoneCraniotomyDecompressioninthetreatmentofpatientswithseverecerebra

3、lhedgeinjury.Methods86casesofpatientswithseverecerebralhedgeinjuryadmittedtoourhospitalfromSeptember2013toSeptember2015wereconvenientselectiondastheresearchobject.Thepatientsweredividedintotwogroupsaccordingtodifferentsurgicalprocedures.43casesofpatientsweretreatedwithstandardlargebonecran

4、iotomydecompressionandservedasthecontrolgroup，andtheother43patientsweretreatedwithmodifiedlargetraumalargebonecraniotomyandservedastheobservationgrouptoobserveintracranialpressure,prognosisandcomplicationsofthepatientsintwogroups.ResultsTherewasnodifferencebetweenthetwogroupsinpreoperative

5、intracranialpressurewith；afterIdand3doftheoperation,thelevelsofintracranialpressureintheobservationgroupweresignificantlylowerthanthatofthecontrolgroupwith.Theprognosisoftheobservationgroupwassignificantlybetterthanthatofthecontrolgroupwith.Theincidenceofcomplicationsintheobservationgroupa

6、ndthecontrolgroupwere9.30%and27.91%respectively.Theobservationgroupwassignificantlylowerwith.ConclusionTheadoptionofmodifiedtraumalargebonecraniotomydecompressionhassignificanttherapeuticeffect，effectivelylowtheintracranialpressurelevel，andimprovepatients'prognosiswithfewcomplicationsandhi

7、ghersafetyonpatientswithseverecerebralhedgeinjurysothatifsworthyofpopularizationandapplication.[Keywords]CraniocerebralInjury；LargeBoneCraniotomyDecompression；ModifiedTraumaLargeBoneCraniotomyDecompression；ClinicalEfficacy重型颅脑对冲伤是颅脑外伤最严重的一种，常伴有严重脑挫裂伤及硬膜下血肿，致死致