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目的比较预见性、相继性双侧去骨瓣减压术治疗重型颅脑损伤的临床疗效。方法以封丘县人民医院2011年5月至2014年5月收治的100例重型颅脑损伤患者为研究对象,随机将其分为两组,每组50例,对照组采取相继性双侧去骨瓣减压术,实验组行预见性双侧去骨瓣减压术,3个月后复诊,比较两组临床疗效及并发症发生率。结果术后3个月时复诊,实验组恢复良好率、病死率分别为40.0%、6.0%,与对照组的18.0%、30.0%比较差异有统计学意义(P<0.05)。另外两组术中急性脑组织膨出、术后切口疝、术后肺部感染及应激性溃疡发生率比较差异有统计学意义(P<0.05)。结论相比相继性双侧去骨瓣减压术,预见性双侧去骨瓣减压术更能明显改善重型颅脑损伤患者预后效果,并发症发生率相对更少。
Objective To compare the predictive and sequential bilateral decompressive craniectomy in the treatment of severe craniocerebral injury. Methods One hundred patients with severe craniocerebral injury admitted to Fengqiu People’s Hospital from May 2011 to May 2014 were randomly divided into two groups (n = 50 in each group). The control group was treated with bilateral Decompression of the flap, the experimental group underwent bilateral decompressive craniectomy, 3 months after the referral, the two groups were compared the clinical efficacy and incidence of complications. Results The patients were followed up 3 months after operation. The recovery rate and the case fatality rate in the experimental group were 40.0% and 6.0%, respectively, which were significantly different from those in the control group (18.0% and 30.0%, P <0.05). The other two groups of intraoperative acute brain swelling, postoperative incisional hernia, postoperative pulmonary infection and stress ulcer incidence difference was statistically significant (P <0.05). Conclusion Compared with sequential bilateral debridement decompression, the predictive bilateral decompressive craniectomy can significantly improve the prognosis of patients with severe craniocerebral injury, the incidence of complications is relatively less.