Effect observation of standard decompressive craniotomy in treatment of patients with severe craniocerebral injury
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摘要: 目的 探讨标准大骨瓣减压术治疗重型颅脑损伤患者的效果。 方法 将150例重型颅脑损伤患者随机分为观察组(n=75)和对照组(n=75)。对照组采用常规去骨瓣开颅术,观察组采用标准大骨瓣减压术。采用格拉斯哥预后评分(GOS)评估2组临床疗效,比较2组手术前后颅内压水平、日常生活活动能力(ADL)分级、格拉斯哥昏迷评分(GCS)、并发症发生情况。 结果 2组术后颅内压水平、ADL分级均低于术前, GCS评分高于术前,且观察组术后颅内压水平、ADL分级低于对照组, GCS评分高于对照组,差异均有统计学意义(P<0.05)。观察组总有效率为93.33%, 高于对照组的82.67%, 差异有统计学意义(P<0.05)。观察组并发症总发生率为6.67%, 低于对照组的18.67%, 差异有统计学意义(P<0.05)。 结论 采用标准大骨瓣减压术治疗重型颅脑损伤患者的疗效显著,可有效降低颅内压水平、ADL分级评分,提高GCS评分,改善术后生活自理能力,降低并发症发生率。Abstract: Objective To investigate the effect of standard decompressive craniotomy in treatment of patients with severe craniocerebral injury. Methods Totally 150 patients with severe craniocerebral injury were randomly divided into observation group(n=75)and control group(n=75). The control group was treated with routine craniotomy, and the observation group was treated with standard decompressive craniotomy. Glasgow Outcome Scale(GOS)was used to evaluate the clinical efficacy of the two groups. Intracranial pressure level, classification of activities of daily living(ADL), Glasgow Coma Scale(GCS)and complications were compared between the two groups before and after operation. Results The postoperative intracranial pressure level and ADL grading in both groups were significantly lower than those before operation, GCS score was significantly higher than that before operation, and intracranial pressure level and ADL grading of the observation group were significantly lower than those of the control group, while GCS score was significantly higher than that of control group(P<0.05). The total effective rate of the observation group was 93.33%, which was significantly higher than 82.67% of the control group(P<0.05). The total incidence of complications in the observation group was 6.67%, which was significantly lower than 18.67% in the control group(P<0.05). Conclusion Standard decompressive craniotomy is effective in the treatment of patients with severe craniocerebral injury, which can effectively reduce intracranial pressure level and score of ADL grading, increase GCS score, improve postoperative self-care ability, and reduce the incidence of complications.
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