林瑞杰??陈伟健??郭谷生

[摘要] 目的 觀察颅脑损伤合并恶性颅内高压的患者，使用标准外伤大骨瓣开颅手术治疗的临床效果。 方法 选取我院颅脑损伤合并恶性颅内高压患者50例（2014年3月3日～2017年3月3日期间），将其依据随机数字表法分两组，各25例。一组给予传统开颅手术（对照组），另一组使用标准外伤大骨瓣开颅手术治疗（观察组），对比两组颅内压力情况，运动/语言情况。 结果 术前两组对比颅内压力情况无统计学意义（P>0.05）。术后观察组颅脑损伤合并恶性颅内高压患者的颅内压力情况优于对照组，且术后一周观察组数据为（14.93±3.83）mm Hg，两组数据对比性较高（P<0.05）。观察组颅脑损伤合并恶性颅内高压患者的运动Ⅰ～Ⅲ级数据96.00%，语言能力障碍Ⅰ～Ⅱ级数据92.00%，优于对照组（P<0.05）。 结论 对颅脑损伤合并恶性颅内高压的患者采用标准外伤大骨瓣开颅手术的方案治疗后，能够有效降低患者的颅内压力，并改善患者的运动能力和语言能力。

[关键词] 传统开颅手术；标准外伤大骨瓣开颅手术；颅脑损伤合并恶性颅内高压

[中图分类号] R651.15 [文献标识码] A [文章编号] 2095-0616（2017）11-221-03

Research on standard large trauma craniectomy in treatment of craniocerebral injury combined with malignant intracranial hypertension

LIN Ruijie CHEN Weijian GUO Gusheng

Department of Neurosurgery，Shantou Chaoyang District People's Hospital，Shantou 515100，China

[Abstract] Objective To observe the clinical effect of standard large trauma craniectomy in treatment of patients with craniocerebral injury combined with malignant intracranial hypertension. Methods 50 patients with craniocerebral injury combined with malignant intracranial hypertension in our hospital from March 3rd，2014 to March 3rd，2017 were selected.They were divided into two groups according to random number table，with 25 in each.One group was given traditional craniotomy （the control group） while the other group was given standard large trauma craniectomy （the observation group）.Intracranial pressure，exercise and speech of patients in two groups were compared. Results There was no difference in intracranial pressure before surgery in two groups，P>0.05.After operation，intracranial pressure of patients with craniocerebral injury combined with malignant intracranial hypertension in the observation group was better than that of the control group.And data of one week after surgery in the observation group was （14.93±3.83）mm Hg.There was a significant comparison of data in two groups （P<0.05）.Data of Ⅰ-Ⅲ exercising and Ⅰ-Ⅱ language barrier of patients with craniocerebral injury combined with malignant intracranial hypertension in the observation group were respectively 96.00% and 92.00%，better than those of the control group，P<0.05. Conclusion Standard large trauma craniectomy in treatment of patients with craniocerebral injury combined with malignant intracranial hypertension can effectively decrease intracranial pressure of patients and improve exercising ability and language ability.

[Key words] Traditional craniotomy；Sandard large trauma craniectomy；Craniocerebral injury combined with malignant intracranial hypertension

有关资料显示，跌伤、坠落以及车祸等因素造成的颅脑损伤疾病[1]，非常容易引发恶性颅内高压，继而对患者的生命安全造成严重的威胁[2-3]。临床上目前而言，主要采取标准外伤大骨瓣开颅手术对此类患者进行治疗[4]，本文当中，采取对比的方式，一组选择标准外伤大骨瓣开颅手术方案，另一组实施传统开颅手术治疗，旨在针对颅脑损伤合并恶性颅内高压疾病患者进行研究，现报道如下。

1 资料与方法

1.1 一般资料

选取在我院治疗颅脑损伤合并恶性颅内高压患者（共收集50例），所选时间属于2014年3月3日～2017年3月3日期间。纳入颅脑损伤合并恶性颅内高压患者标准：（1）符合疾病的诊断；（2）患者经过CT等检测，其血肿量超过10.00mL；（……