程晓午

[摘要] 目的 探讨改良大骨瓣开颅减压术在重型颅脑损伤中的临床效果。 方法 随机选取了2010年2月—2015年2月期间来该院治疗的200例重型颅脑损伤患者作为研究对象，利用计算机软件把200例患者随机分成两组，观察组和对照组，每组100例患者。给予对照组传统大骨瓣开颅减压术治疗，观察组改良大骨瓣开颅减压术治疗，比较观察两组治疗效果。 结果 观察组治疗有效率为46%，对照组治疗有效率为34%；观察组术后不良反应率为10.32%，对照组为22%。观察组明显优于对照组，两组差异有统计学意义（P<0.05）。 结论 使用改良大骨瓣开颅减压术对重型颅脑损伤患者进行治疗疗效确切，可将患者治疗过程中的并发症状有效减少，可临床推广。

[关键词] 改良大骨瓣开颅减压术；重型颅脑损伤；临床意义分析

[中图分类号] R651.15 [文献标识码] A [文章编号] 1674-0742（2015）09（c）-0043-02

[Abstract] Objective To investigate the clinical effect of improved large decompressive craniotomy on severe brain injury. Methods 200 cases with severe brain injury treated in our hospital from February 2010 to February 2015 were selected as the subjects and randomly divided into two groups， the observation group and the control group with 100 cases in each by the computer software. Patients in the control group were treated by the traditional large decompressive craniotomy， and those in the observation group were treated by improved large decompressive craniotomy. And the treatment effect of the two groups was observed and compared. Results The response rate was much higher in the observation group than that in the control group（46% vs 34%）， the postoperative incidence of adverse reactions was much lower in the observation group than that in the control group（10.32% vs 22%）， the difference between the two groups was statistically significant （P<0.05）. Conclusion For patients with severe brain injury， improved large decompressive craniotomy has exact effect， which can effectively reduce the incidence of complications during the treatment， so it can be promoted clinically.

[Key words] Improved large decompressive craniotomy； Severe brain injury； Analysis of the clinical significance

重型颅脑损伤是外科临床治疗常见的致残率、致死率较高的病症，主要致病原因为暴力作用。主要临床表现为患者意识障碍、昏迷、脑挫裂、颅脑出血等，临床抢救治疗的原则是在短时间内将患者颅内高压有效降低。当前临床治疗中常见的方式为大骨瓣开颅减压术，但临床治疗中创伤性大并且有较多并发症状，对患者预后效果和生活质量造成了严重影响[1]。为探究改良大骨瓣开颅减压术在重型颅脑损伤中的临床效果，随机选取了2010年2月—2015年2月期间来该院治疗的200例重型颅脑损伤患者作为研究对象，现报道如下。

1 资料与方法

1.1 一般资料

随机选取了来该院治疗的200例重型颅脑损伤患者作为研究对象，男性123例，女性77例，年龄在12～74岁之间，平均年龄（45.36±10.58）岁。把所有患者随机分成两组对照组和观察组，每组分别100例患者。……