【摘要】 目的 探讨改良外伤大骨瓣减压术治疗重型颅脑损伤的临床疗效及对预后的影响。方法 将78例重型颅脑损伤患者按手术方法不同分为两组,各39例。对照组采用标准外伤大骨瓣减压术治疗,观察组采用改良外伤大骨瓣减压术治疗。比较不同时点两组格拉斯哥昏迷量表评分、血清炎性因子(白细胞介素6、肿瘤坏死因子α、超敏C反应蛋白)水平、格拉斯哥预后量表评分、术后并发症发生率。结果 观察组术后7 d格拉斯哥昏迷量表评分及术后1个月格拉斯哥预后量表评分显著高于对照组(P<0.01),血清白细胞介素6、肿瘤坏死因子α及超敏C反应蛋白水平显著低于对照组(P<0.01),术后并发症发生率显著低于对照组(P<0.05)。结论 改良外伤大骨瓣减压术能明显减轻重型颅脑损伤患者的炎症反应,改善意识状态,促进术后恢复,安全性高。更多还原

【Abstract】 Objective To investigate the clinical effect of modified trauma decompression of large bone flap in the treatment of severe head injury and its influence on prognosis.Methods 78 patients with STBI were divided into two groups according to different surgical methods,39 cases each.The control group was treated with standard traumatic large bone flap decompression,and the observation group was treated with modified trauma large bone flap decompression.The Glasgow Coma Scale(GCS) score,serum inflammatory factors(IL-6,TNF-α, hs-CRP),GOS score and postoperative complication rate of the two groups were compared.Results The observation group’ s GCS score at 7 d after surgery and GOS score at 1 month after surgery were were significantly higher than those of the control group(P<0.01),and the serum levels of IL-6,TNF-α and hs-CRP were significantly lower than those of the control group(P<0.01).The incidence of postoperative complications was significantly lower than that of the control group(P<0.05).Conclusions Modified large bone flap decompression for STBI patients can reduce inflammation,improve consciousness,promote postoperative recovery,and have high safety.更多还原