双侧去骨瓣减压术在双侧不对称性重型颅脑损伤中的临床效果研究.docVIP

双侧去骨瓣减压术在双侧不对称性重型颅脑损伤中的临床效果研究 　　[摘要] 目的 探讨双侧去骨瓣减压术对双侧不对称性重型颅脑损伤的临床治疗效果。 方法 选择2008年4月～2011年12月浙江省宁波市第一医院收治的双侧不对称性重型颅脑损伤患者61例为研究对象，随机分为观察组31例，对照组30例。观察组采用双侧去骨瓣减压术，对照组采用单侧标准外伤大骨瓣手术。治疗3个月后患者均行格拉斯哥预后（GOS）评估，比较两组患者术中急性脑组织膨出及术后切口疝发生率、GOS评分及并发症情况。 结果 ①治疗后，观察组术中急性脑组织膨出、术后切口疝发生率均明显低于对照组（9.7%、50.0%比12.9%、53.3%），差异均有统计学意义（均P 0.05）。③观察组术后并发症发生率明显低于对照组（19.4%比50.0%），差异有统计学意义（P 0.05）。 结论 双侧去骨瓣减压术治疗双侧不对称性重型颅脑损伤，其术中并发症发生率及病死率较低，治疗效果及术后预后较好，值得临床推广使用。 　　[关键词] 双侧去骨瓣减压术；单侧标准外伤大骨瓣术；双侧不对称性重型颅脑损伤 　　[中图分类号] R651.15 [文献标识码] A [文章编号] 1673-7210（2014）02（b）-0050-03 　　Clinical research of bilateral decompressive craniectomy in treating bilateral asymmetrical severe craniocerebral injury 　　FEI Bing1 LING Jie2 　　1.The First Hospital of Ningbo City， Zhejiang Province， Ningbo 315000， China； 2.Department of Clinical Laboratory， Huangyan Hospital Affiliated to Wenzhou Medical University， Zhejiang Province， Huangyan 318020， China 　　[Abstract] Objective To investigate the clinical efficacy of bilateral decompressive craniectomy in the treatment of bilateral asymmetrical severe craniocerebral injury. Methods 61 patients with bilateral asymmetrical severe craniocerebral injury treated in the First Hospital of Ningbo City from April 2008 to December 2011 were selected and randomly divided into two groups. 30 patients in control group and 31 patients in observation group， patients in observation group were treated with bilateral decompressive craniectomy， and patients in control group were treated with unilateral standard large trauma craniotomy. The Glasgow outcome score （GOS） of all patients in both groups was evaluated 3 months after treatment， the occurrence rate of intraoperative acute brain tissue bulging and postoperative incision hernia between the two groups were compared； GOS scores and complication were observed. Results ①After treatment， incidence of acute intraoperative encephalocele and incidence of postoperative incisional hernia of observation group patients were significantly low