脑膜补片联合大骨瓣减压术治疗重度颅脑损伤的临床效果.doc

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1、脑膜补片联合大骨瓣减压术治疗重度颅脑损伤的临床效果朱福彬廖振华等【论文摘要】目的探讨脑膜补片联合大骨瓣减压术治疗重度颅脑损伤的临床效果。方法选取2013年12月〜2015年2月到我院就诊的88例重度颅脑损伤患者，按照随机数字表法将其分为观察组和对照组，每组44例。对照组采取大骨瓣减压术治疗，观察组在此基础上联合脑膜补片治疗，比较两组的治疗效果。结果观察组预后良好率为59.1%,高于对照组的25.0%；死亡率为9.1%,低于对照组的29.6%；两组差异有统计学意义(P<0.05)。两组的NIHSS评分均低于治疗前，且观察组的NIHSS评分低于对照组，差异有统计学意义(P<0

2、.05)o观察组术后脑膨出、脑积水、颅内感染、脑脊液漏的发生率低于对照组，差异有统计学意义(P<0.05)o结论脑膜补片联合大骨瓣减压术治疗重度颅脑损伤的效果显著，临床价值高。【论文关键词】重度颅脑损伤；脑膜补片；大骨瓣减压术Clinicaleffectofdurapatchcombinedwithlargeboneflapdecompressioninthetreatmentofseverecraniocerebraltrauma[Abstract]ObjectiveToinvestigatetheclinicaleffectofdurapatchcombinedwit

3、hlargeboneflapdecompressioninthetreatmentofseverecraniocerebraltrauma.Methods88patientswithseverecraniocerebraltraumaadmittedintoourhospitalfromDecember2013toFebruary2015wereselected.Theyweredividedintoobservationgroupandcontrolgroupaccordingtotherandomnumbertablemethod,with44casesineachg

4、roup.Thecontrolgroupwastreatedwithlargeboneflapdecompression,theobservationgroupwastreatedwithduralpatchonthebasicofcontrolgroup.Thetherapeuticeffectintwogroupswascompared.ResultsThegoodprognosisrateinobservationgroupwas59.1%,whichwassignifleantlyhigherthan25.0%ofcontrolgroup,andmortality

5、ratewas9.1%,whichwaslowerthan29.6%ofcontrolgroup.Thedifferencesbetweentwogroupsweresignificant(P<0.05).NIHSSscoreintwogroupswaslowerthanthebeforetreatment,andNIHSSscoreinobservationgroupwaslowerthanthecontrolgroup(P<0.05).Theincidencerateofencephalocele,hydrocephalus,intracranialinfection

6、,cerebrospinalfluidleakageinobservationgroupwerelowerthanthoseofthecontrolgroup.Thedifferenceswerestatisticallysignificance(P<0.05).ConclusionDurapatchcombinedwithlargeboneflapdecompressioninthetreatmentofseverecraniocerebraltraumaiseffectiveandclinicalvalueishigh.[Keywords]Severecranioce

7、rebraltrauma；Duralpatch；Largeboneflapdecompression标准大骨瓣减压术是临床常用的急性颅内血肿清除术，对重型颅脑损伤或合并脑疝、广泛硬膜下血肿、脑挫裂伤、脑水肿等疾病起到显著的治疗效果[l]o重度颅脑损伤(颅骨和硬脑膜缺损等)患者行大骨瓣减压术后，易出现脑膨出等症状，对患者术后神经功能恢复及预后质量产生严重影响[2],因此对重度颅脑损伤患者采取大骨瓣减压术治疗时，联合脑膜补片修补可促进患者术后康复。本研究以44例重度颅脑损伤患者作为研究对象，采取脑膜补片联合大骨瓣减压术进行治疗，取