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目的:探讨标准外伤大骨瓣开颅术与常规骨瓣开颅术治疗重型颅脑损伤的临床疗效。方法:收集我院2011年1月到2015年1月收治的重型颅脑损伤患者80例,按照随机数字表法分为观察组和对照组,每组40例,患者术前均给予常规护理,观察组给予标准外伤大骨瓣开颅术,对照组给予常规骨瓣开颅术,采用格拉斯哥预后评分(GOS)法评价两组术后12个月疗效,比较两组术前和术后7 d患者颅内压变化,记录两组患者并发症发生情况。结果:观察组疗效、良好率、存活率均显著高于对照组(P<0.05)。治疗后7 d两组颅内压差异具有统计学意义(P<0.05),并且两组术后7d与治疗前相比差异均具有统计学意义(P<0.05)。观察组脑切口疝发生率为2.5%,明显低于对照组的20.0%,差异具有统计学意义(P<0.05)。结论:标准外伤大骨瓣开颅术治疗效果优于常规骨瓣开颅术,具有一定安全性,值得临床推荐。
Objective: To investigate the clinical effect of craniotomy with standard trauma craniectomy and conventional craniotomy on severe craniocerebral injury. Methods: Eighty patients with severe craniocerebral injury admitted in our hospital from January 2011 to January 2015 were divided into observation group and control group according to the random number table method, 40 cases in each group. The patients were given routine nursing before operation, The patients in the observation group were given standard craniotomy for large trauma and the control group were given conventional craniotomy. The Glasgow Outcomes Scale (GOS) was used to evaluate the efficacy of the two groups at 12 months after operation. The preoperative and postoperative 7 days Patients with intracranial pressure changes, recording the incidence of complications in two groups of patients. Results: The curative effect, good rate and survival rate in the observation group were significantly higher than those in the control group (P <0.05). The differences of intracranial pressure between the two groups were statistically significant on the 7th day after treatment (P <0.05), and the difference between the two groups after 7 days was statistically significant (P <0.05). The incidence of brain incisional hernia in observation group was 2.5%, which was significantly lower than that in control group (20.0%) (P <0.05). Conclusion: The treatment of standard trauma craniectomy is superior to conventional craniotomy, which is safe and worthy of clinical recommendation.