摘要
目的观察不同减压方式对大骨瓣减压术重型颅脑损伤患者预后的影响。方法选择2017年1月~2018年6月在我院进行治疗的重型颅脑损伤患者60例为研究对象,根据来诊时间排序,序列号单号为观察组,双号为对照组,每组30例。对照组患者采用传统外伤大骨瓣减压术进行治疗,观察组患者行改良去骨瓣减压术治疗。观察两组患者经过治疗45 d后的死亡率、清醒率以及患者意识恢复时间。随访患者6个月,使用格拉斯哥预后评分(GOS)对两组患者预后进行评价。结果治疗45 d后观察组患者死亡率明显低于对照组,清醒率明显高于对照组,观察组意识恢复时间明显短于对照组,差异有统计学意义(P<0.05)。6个月随访后观察组患者预后良好率为83.33%明显高于对照组的60.00%,预后不良患者比例明显低于对照组;观察组患者GOS评分明显高于对照组,差异有统计学意义(P<0.05)。结论与传统大骨瓣减压术比较,改良去骨瓣减压术能够明显降低患者死亡率,改善患者预后,具有重要的临床应用价值。
Objective To observe the effect of different decompression methods on the prognosis of patients with severe craniocerebral injury undergoing large decompressive craniectomy. Methods 60 patients with severe craniocerebral injury who were treated in our hospital from January 2017 to June 2018 were selected as study subjects. According to the time order of consultation, the odd serial number was in the observation group, and the even number was in the control group, with 30 cases in each group. Patients in the control group were treated with traditional traumatic large decompressive craniectomy. Patients in the observation group were given modified decompressive craniectomy. The number of deaths, the number of awake patients, and the recovery time of patients' consciousness after 45 days of treatment were observed in both groups. Patients were followed up for 6 months and the prognosis was evaluated using the Glasgow Outcome Score (GOS). Results After 45 days of treatment, the mortality in the observation group was significantly lower than that in the control group. The awake rate was significantly higher than that in the control group. The consciousness recovery time in the observation group was significantly shorter than that in the control group, and the difference was statistically significant(P<0.05). After 6 months of follow-up, the good prognosis rate in the observation group was 83.33%, which was significantly higher than that in the control group(60.00%). The proportion of patients with poor prognosis was significantly lower than that in the control group;the GOS score in the observation group was significantly higher than that in the control group, and the difference was statistically significant (P<0.05). Conclusion Compared with traditional large decompressive craniectomy, modified decompressive craniectomy can significantly reduce patients' mortality and improve patients' prognosis, and has an important clinical application value.
作者
曾凡锋
ZENG Fanfeng(Department of Neurosurgery, the People’s Hospital of Jianyang City in Sichuan Province, Jianyang 641400, China)
出处
《中国现代医生》
2019年第23期56-58,共3页
China Modern Doctor
关键词
大骨瓣减压术
减压方式
重型颅脑损伤
改良去骨瓣减压术
Large decompressive craniectomy
Decompression method
Severe craniocerebral injury
Modified decompressive craniectomy
