【摘要】 目的:探讨标准外伤大骨瓣开颅术治疗重型颅脑损伤的有效性及安全性。方法:选取我院重型颅脑损伤患者为研究对象,随机分为传统手术组(传统骨瓣开颅术)和改良手术组(标准外伤大骨瓣开颅术)。比较两组术后颅内压变化、手术治疗效果及术后并发症发生情况;所有患者随访6个月并采用格拉斯哥预后评分(GOS)进行评价。结果:改良手术组术后第3天、术后第7天颅内压均优于同期传统手术组;且术后美国国立卫生研究院卒中量表(NIHSS)评分以及术后并发症发生率均低于传统手术组;差异均有统计学意义(P<0.05);改良手术组治疗临床总有效率(86.67%)高于传统手术组(66.67%),预后良好率(53.33%)高于传统手术组(26.67%),但差异均无统计学意义(P>0.05)。结论:相对传统骨瓣开颅术,标准外伤大骨瓣开颅术治疗重型颅脑损伤临床疗效更佳,可降低术后并发症发生率,改善患者预后,值得推广。更多还原

【Abstract】 Objective: To evaluate the efficacy and safety of standard large trauma craniotomy in the treatment of severe traumatic brain injury. Methods:Patients of severe traumatic brain injury treated in our hospital were included,and randomly divided into conventional craniotomy group and modified standard large trauma craniotomy group. The two groups were compared concerning the changes of intracranial pressure before and after operation,surgical outcomes and complications. All patients were followed up for 6 months and evaluated with the Glasgow outcome scale( GOS) for the prognosis. Results:Patients treated with modified standard large trauma craniotomy had better improved intracranial pressure in the 3 rd and 7 th day following surgery as well as lower scoring on the national institute of health stroke scale( NIHSS) and postoperative complications than those treated with conventional craniotomy.The difference was significant( P < 0. 05). Total clinical efficacy and good prognosis were 86. 67% and 53. 33%,66. 67% and 26. 67%,respectively for the modified standard large trauma craniotomy group and conventional craniotomy group,yet the difference was insignificant( P > 0. 05). Conclusion:Standard large trauma craniotomy for severe traumatic brain injury may lead to better clinical outcomes,including significantly reduced postoperative complications and better improved prognosis than the conventional craniotomy,and is worthy of wider clinical recommendation.更多还原