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目的:探讨和观察大骨瓣开颅术治疗重型颅脑损伤致脑疝的临床效果。方法:收集2012年8月至2014年7月来我院神经外科就诊的重型颅脑损伤致脑疝患者110例,随机分为试验组和对照组,各55例。试验组给予大骨瓣开颅术,对照组给予常规骨瓣开颅术,术后均给予常规对症治疗和重症护理,观察两组患者手术前后颅内压变化和神经功能缺损评分,以及治疗有效率。结果:试验组患者治疗后颅内压和神经功能缺损评分均小于对照组,而治疗有效率高于对照组,上述差异分别经t检验或卡方检验比较,差异均有统计学意义(P<0.05)。结论:大骨瓣开颅术治疗重型颅脑损伤致脑疝可有效降低患者颅内压和神经功能缺损,提高治疗效果。
Objective: To investigate and observe the clinical effect of craniectomy with craniocerebral craniotomy in treating severe brain injury induced by cerebral hernia. Methods: A total of 110 patients with cerebral hernia caused by severe craniocerebral injury who received neurosurgery in our hospital from August 2012 to July 2014 were randomly divided into test group and control group, with 55 cases in each group. The experimental group was given a large craniotomy and the control group was given conventional craniotomy. All patients were given conventional symptomatic treatment and intensive care. The changes of intracranial pressure and neurological deficit scores before and after operation were observed, effectiveness. Results: The scores of intracranial pressure and neurological deficit in the experimental group were less than those of the control group after treatment, but the treatment efficiency was higher than that of the control group. The differences were statistically significant by t test or chi square test (P < 0.05). Conclusion: Treating craniocerebral hernia caused by severe craniocerebral injury with large bone flap craniotomy can effectively reduce intracranial pressure and neurological deficit, and improve the therapeutic effect.