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目的探讨双侧标准外伤大骨瓣减压术在治疗特重型颅脑损伤中的作用。方法 2006年1月至2011年12月收治的130例特重型颅脑损伤施行标准外伤大骨瓣减压手术患者的临床资料进行回顾性分析,其中2006年1月至2008年12月仅行单纯病灶侧标准外伤大骨瓣减压手术64例(A组),2009年1月至2011年12月采用双侧标准外伤大骨瓣减压术66例(B组),将两组患者的颅内压、术后并发症及预后情况进行比较分析。结果采用双侧标准外伤大骨瓣减压术组较单纯病灶侧标准外伤大骨瓣减压手术组颅内压下降更明显,差异有统计学意义(P<0.01),按GOS治疗结果,B组良好率较A组提高了17.2%,B组病死率较A组下降13.2%(P<0.05)。结论双侧标准外伤大骨瓣减压术可有效降低特重型颅脑损伤患者的病死率及急性脑膨出和脑梗死的发生率,对改善特重型颅脑损伤患者的预后,提高其生存质量起到了积极的作用。
Objective To investigate the effect of bilateral standard trauma craniectomy on the treatment of extra-severe craniocerebral injury. Methods A retrospective analysis was performed on the clinical data of 130 patients with severe traumatic brain injury undergoing major traumatic decompressive craniectomy admitted from January 2006 to December 2011. Among them, the clinical data of January 2006 to December 2008 were only simple Sixty-four patients (group A) with lesion-side standard trauma and large bone flap decompression surgery (B group) were treated with bilateral standard traumatic major bony decompression (B group) from January 2009 to December 2011. The two groups of patients’ Internal pressure, postoperative complications and prognosis were compared. Results The bilateral intracranial pressure was significantly lower than that of bilateral traumatic metacarpal decompressive surgery group (P <0.01). According to the results of GOS treatment, B The rate of good group was 17.2% higher than that of group A, and the mortality rate of group B was 13.2% lower than that of group A (P <0.05). Conclusion Bilateral bilateral standard trauma decompressive craniectomy can effectively reduce the mortality of patients with severe traumatic brain injury and the incidence of acute cerebral edema and cerebral infarction, improve the prognosis of patients with extra-severe traumatic brain injury and improve their quality of life Played a positive role.