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目的探讨标准大骨瓣减压术与传统去骨瓣减压术治疗颅脑损伤致大面积脑梗死患者的临床效果比较。方法选取2015年1月至2016年2月营口市中心医院收治的81例颅脑损伤致大面积脑梗死患者作为研究对象,对照组(40例)患者给予传统去骨瓣减压术治疗,观察组(41例)患者则给予标准大骨瓣减压术治疗,比较两组患者治疗效果、术后并发症发生率、手术前后脑梗死面积及格拉斯哥昏迷评分量表(GCS)评分。结果术后观察组恢复良好+中等残疾患者比例明显高于对照组,差异均有统计学意义(均P<0.05);术后7 d,观察组患者脑梗死面积明显小于对照组,GCS评分明显高于对照组,差异均有统计学意义(均P<0.05);观察组患者术后并发症发生率(22.0%)明显低于对照组(50.0%),差异有统计学意义(P<0.05)。结论标准大骨瓣减压术在颅脑损伤大面积脑梗死患者中的应用效果相较于传统去骨瓣减压术临床效果显著,能有效降低患者病死率,并缩小术后脑梗死面积。
Objective To investigate the clinical effects of standard decompressive craniectomy and traditional decompressive craniectomy on craniocerebral injury caused by large area cerebral infarction. Methods From January 2015 to February 2016, Yingkou Central Hospital treated 81 patients with craniocerebral injury caused by large area cerebral infarction as the object of study. The control group (40 patients) was treated by conventional decompressive craniectomy. The patients in group (41 cases) were treated with standard decompressive craniectomy. The therapeutic effect, the incidence of postoperative complications, the area of cerebral infarction before and after surgery and the Glasgow Coma Scale (GCS) were compared between the two groups. Results The postoperative observation group recovered well + the proportion of moderate disability patients was significantly higher than that of the control group, the differences were statistically significant (all P <0.05); 7 d after operation, the observation group patients with cerebral infarction area was significantly smaller than the control group, GCS score significantly (P0.05) .The incidence of postoperative complications in the observation group (22.0%) was significantly lower than that in the control group (50.0%), the difference was statistically significant (P0.05 ). Conclusion The standard large flap decompression in patients with craniocerebral injury in large area cerebral infarction compared with the traditional clinical effect of decompressive craniectomy significantly, can effectively reduce the patient mortality and reduce the area of postoperative cerebral infarction.