改良去骨瓣减压术在重型颅脑损伤患者中的应用-东南大学学报医学版

改良去骨瓣减压术在重型颅脑损伤患者中的应用

单位：东南大学医学院附属马鞍山市人民医院神经外科,安徽马鞍山 243000

分类号：R651.15

出版年·卷·期（页码）：2012·31·第五期（610-612）

摘要：

目的:比较分析改良去骨瓣减压术与传统标准外伤大骨瓣减压术治疗重型颅脑损伤的疗效。方法:选取54例重型颅脑损伤患者,随机分为改良去骨瓣减压组26例和标准外伤大骨瓣组28例,比较两组手术前后格拉斯哥昏迷评分(GCS)和术后3个月格拉斯哥预后评分(GOS)分级结果。结果:改良去骨瓣减压组术后1周、2周格拉斯哥昏迷评分比标准外伤大骨瓣组高(P<0.05或P<0.01);格拉斯哥预后评分显示改良去骨瓣减压组预后较好,差异有统计学意义(P<0.05)。结论:改良去骨瓣减压术比传统标准外伤大骨瓣减压术更能充分减压,能有效保护脑功能,可显著改善重型颅脑损伤患者的预后。

Objective: To compare and analyze the therapeutic effect between improvement craniotomy and standard trauma craniotomy in severe brain injury. Methods: 54 patients with severe brain injury were randomly divided into the improvement craniotomy group and the standard trauma craniotomy group. The GCS and GOS was compared between the two groups before and after the operation. Results: The improvement craniotomy group’s GCS at 1,2 week after operation and GOS at three mouths after operation recover were better than the standard trauma craniotomy group (P<0.05 or P<0.01). Conclusion: The improvement craniotomy can more thoroughly decompress and more utility conservate the brain function than the standard trauma craniotomy, and can obviously improve the prognosis of the patients with severe brain injury.

参考文献：

[1] RICHARDWINN H,SPETZLER R F,MEYER F B,et al.郑永日译.脑外伤的外科治疗[M]//王任直主译.尤曼斯神经外科学.5版.北京:人民卫生出版社,2009:4104-4106.
[2] MAAS A I R,EARDEN M,TEASDALE G M,et al.EBIC—guidelines for management of severe head injury in adults[J].Acta Neurochir(Wien),1997,139:286-294.
[3] American Association of Neurological Surgeons.Guidelines for the anagement of severe head injury.Brain Trauma Foundation,American Association of Neurological Surgeons,Ioint Section on Neurotrauma and Critical Care[J].Neurotrauma,1996,13:639-734.
[4] 王国军,苏静,于春江.早期标准外伤大骨瓣减压术治疗大面积脑梗死[J].中华急诊医学杂志,2007,16(11):1209-1212.
[5] 招康东,招建华,林小清,等.不同颅内减压术和二次脑损伤因素对重型颅脑损伤患者预后的影响[J].广东医学院学报,2009,27(4):395-397.
[6] COPLIN W M, CULLEN N K, POLICHERLA P N, et al.Safty and feasibility of craniectomy with duraplasty as the initial surgical intervention for severe traumatic brain injury[J].J Trauma,2001,50(6):1050-1059.
[7] LÜ L Q,JIANG J Y,YANG M K,et al.Standard large trauma craniotomy for severe traumatic brain injury[J].Chinese Journal of Traumatology (English Edition),2003,6(5):302-304.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录