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1、改良去骨瓣减压术治疗重型颅脑损伤的临床研究［摘要］目的探讨重型颅脑损伤患者采取改良去骨瓣减压术的疗效。方法随机选取200例于2010年5月一2015年5月期间该院接收的重度颅脑损伤患者，将其按手术方式的不同分为对照组与实验组，两组分别采用标准外伤大骨瓣减压术和改良去骨瓣减压术，观察两组疗效。结果术后2周，实验组GCS评分为(12.31±2.34)分，对照组为(9・51±1・32)分，实验组GCS评分较对照组明显要高(P〈0.05)；同时治疗后实验组恢复良好率为51.0%、死亡率5.0%、重度残疾8%、
2、轻度残疾29%、植物生存7.0%,而对照组分别为32.0%.14.0%.25.0%、10%、19.0%,实验组预后明显优于对照组(P〈0.05)；另外实验组术后20例(20.0%)发生并发症,而对照组共39例(39.0%)发生并发症，差异有统计学意义(P<0.05)o结论对重度颅脑损伤患者采取改良大骨瓣减压术，疗效显著，值得推广。［关键词］重型颅脑损伤；改良去骨板减压术；疗效［中图分类号］R651.15［文献标识码］A［文章编号］1674-0742(2015)10(a)-0011-03Clinical
3、StudyofImprovedDecompressiveCraniotomyintheTreatmentofSevereCraniocerebralInjuryLIQin-pu,ZHANGMinDepartmentofNeurosurgery,TonghuaCentralHospital,Tonghua,JilinProvince,134000China[Abstract]ObjectiveTostudythecurativeeffectofimproveddecompressivecraniotom
4、yinthetreatmentofseverecraniocerebralinjury.Methods200patientswithseverecraniocerebralinjurytreatedinourhospitalfromMay2010toMay2015wereseiected且nddividedintocontrolgroupandexperimentalgroupaccordingtodifferentoperationschemes.Twogroupsrespectivelyadopt
5、edthestandardlargetraumacraniotomyandimproveddecompressiveeraniotomy.Thecurativeeffectofthetwogroupswasobserved.ResultsTwoweeksaftersurgery,theGCSoftheexperimentaiwassignificantlyhigherthanthatofthecontrolgroup[(12.31±2・34)pointsvs(9.51±1・32)points](P<0
6、.05)；atthesametime,rateofgoodrecovery,mortality,severedisability,milddisability,andpersistentvegetativestatuswas51.0%,5.0%,8%,29%,7.0%respectivelyintheexperimentalgroupand32.0%,14.0%，25.0%,10%and19.0%respectivelyinthecontrolgroup,whichshowedthattheprogn
7、osiswassignificantlybetterintheexperimentalgroupthaninthecontrolgroupwithstatisticaldifference(P<0.05)・Inaddition,thecomplicationratewas20.0%(20cases)intheexperimentaigroupand39.0%(39cases)inthecontrolgroup,andthedifferencewasstatisticallysignificant,P〈
8、0.05.ConclusionTheimproveddecompressivecraniotomyhasanobviouseffectonthemanagementofseverecraniocerebralinjury,thereforeitisworthyofclinicalpromotion.[Keywords]Severecraniocerebralinjury；Improveddecompressivecraniotomy；Curativeef
