目的分析大骨瓣减压手术在重型颅脑损伤中的应用及对血小板活化指标、神经功能的影响。方法选择2014年1月—2016年1月于我院就诊的94例重症颅脑损伤病人,参照抽签法分为对照组和研究组,每组47例,对照组行常规骨瓣减压手术,研究组行大骨瓣减压手术,观察术后两组血小板活化指标[P-选择素(CD62p)、溶酶体跨膜蛋白(CD63)、血小板膜糖蛋白(GP)Ⅱb/Ⅲa、血小板聚集率(PAgT)]、神经功能[神经功能缺损评分(NIHSS)、格拉斯哥昏迷评分(GCS)]、脑灌注压、并发症及预后情况。结果术后,研究组CD62p、CD63、GPⅡb/Ⅲa、PAgT低于对照组,差异有统计学意义(P<0.05);研究组NIHSS、GCS评分优于对照组,差异有统计学意义(P<0.05);研究组脑灌注压优于对照组(P<0.05);研究组并发症率10.64%(5/47)低于对照组36.17%(17/47),差异有统计学意义(P<0.05);研究组预后良好率65.96%(31/47)高于对照组34.04%(16/47),差异有统计学意义(P<0.05)。结论大骨瓣减压手术对重型颅脑损伤的临床效果值得肯定,能促进血小板活化指标的恢复,保护神经功能,改善预后。 Objective To analyze the application of decompressive craniectomy in severe traumatic brain injury and its effect on platelet activation and neurological function. Methods Ninety-four patients with severe craniocerebral injury who were treated in our hospital from January 2014 to January 2016 were divided into control group and study group according to the method of drawing lots, with 47 cases in each group. The control group received conventional decompression of bone flap, The study group was treated with decompressive craniectomy. The indexes of platelet activation such as CD62p, CD63, GP Ⅱb / Ⅲa, platelet aggregation (PAgT), neurological deficit (NIHSS), Glasgow Coma Scale (GCS), cerebral perfusion pressure, complications and prognosis. Results After the operation, the scores of CD62p, CD63, GPⅡb / Ⅲa and PAgT in the study group were lower than those in the control group (P <0.05). The scores of NIHSS and GCS in the study group were better than those in the control group (P < 0.05). The cerebral perfusion pressure in the study group was better than that in the control group (P <0.05). The complication rate in the study group was 10.64% (5/47), which was lower than that in the control group (36.17%, 17/47) 0.05). The good prognosis of the study group was 65.96% (31/47), which was significantly higher than that of the control group (34.04%, 16/47). The difference was statistically significant (P <0.05). Conclusion The clinical effect of decompressive craniectomy for severe craniocerebral injury is worthy of recognition. It can promote the recovery of platelet activation index, protect neurological function and improve prognosis.