不同手术方法治疗重型颅脑创伤致双侧瞳孔散大的疗效研究.pdf

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1、Q第卷第9期JournalofQiqiharUniversityofMedicine．2015．V0I．36．No．9·1325·．经验交流．不同手术方法治疗重型颅脑创伤致双侧瞳孔散大的疗效研究潘仁高谢溢升梁青青【摘要】目的对比采用双额、颞、顶去骨瓣减压术治疗及常规减压术治疗重型颅脑创伤致双侧瞳孔散大的I临床疗效。方法回顾性分析2012年1O月至2014年9月来我院治疗的重型颅脑创伤致双侧瞳孔散大患者98例，将患者分为两组，观察组和对照组(n=49)，观察组采用双额、颞、顶去骨瓣减压术治疗，对照组采用常规减压术治疗，比较两组I临床效果、术后并发症、预后评价。结果观察组存活率显

2、著高于对照组，病死率、并发症总发生率显著低于对照组，差异有统计学意义(P<0．05)。观察组与对照组比较恢复良好率明显较高，重残率明显较低，差异有统计学意义(P<0．05)。结论重型颅脑创伤致双侧瞳孔散大患者采用双额、颞、顶去骨瓣减压术治疗疗效确切，使患者的存活率明显提高，并发症总发生率明显降低，显著改善预后，可以作为一种有效的方法推广使用。【关键词】颅脑创伤；瞳孔散大；手术Researchontheeficacyofdiferentsurgicalmethodsintreatingbilateralmydrlasiscausedbyseveretraumaticbraini

3、njuryPANRen—gao．Thefirstsurgerydepartment，Dongkenghospital，Dongguan，Guangdong，523451，China【Abstract】ObjectiveThisarticlewastocomparetheeficacyofthedualfrontal。temporalandtopdecompresscraniectomydecompressiontherapyandregulardecompressiontherapyinthetreatmentofbilateralmydriasiscausedbysever

4、etraumaticbraininjury．MethodsAretrospectiveanalysisof98caseswithbilateralmydriasiscausedbyseveretraumaticbraininjuryselected，theyhospitalizedinourhospitalduringOctober2012andSeptember2014，thepatientsweredividedintotwogroups，theobservationgroupandthecontrolgroup(n=49)．Thepatientsinobservatio

5、ngroupuseddualfrontal，temporal，parietaldecompresscraniectomytreatment．However，thepatientsinthecontrolgroupusedconventionaldecompressiontherapy．Theclinicalresults，complications，prognosiswerecompared．ResultsThesurvivalrateoftheobservationgroupwassignificantlyhigherthanthecontrolgroup，themorta

6、lityandtheoverallincidenceofcomplicationswassiguificanflylowerthanthecontrolgroup，thediferenceswerestatisticallysignificant(P<0．05)．ComparedwitIlthecontrolgroup，thegoodrecoveryrateoftheobservationgroupwassignificantlyhigher，severedisabilityratewassignificantlylower，thediferenceswerestatisti

7、callysignificant(P<0．05)．ConclusionsInthetreatmentofpatientswi山bilateralmydriasiscausedbyseveretraumaticbraininjury，dualfrontal，temporalandtopdecompresscraniectomycanobtainexacteficacyandsurvivalrateandtheprognosiscanbesignificantlyireproved．theoverallin