刘乔保

[摘要] 目的 比较在重型颅脑损伤治疗中采取常规骨瓣开颅术与标准大骨瓣减压术的临床效果以及应用价值。方法 方便选取该院纳入诊治的2015年9月—2017年9月期间研究的102例重型颅脑损伤患者作为研究样本，该次分组采取随机数字表法的形式，将患者平均分为参照组（n=51例）以及实验组（n=51例），将予以常规骨瓣开颅术患者作为参照组，将实行标准大骨瓣减压术患者作为实验组，观察两组重型颅脑损伤患者抢救的神经功能缺损程度评分、颅内压、并发症发生率、临床手术效果。结果 实验组重型颅脑损伤患者术后良好率62.74%、神经功能缺损程度评分（11.54±1.27）分、颅内压（13.54±2.65）mmHg、并发症发生率3.92%对比参照组各项数据，差异有统计学意义（χ2=3.935 2，t=22.375 6、10.909 6，χ2=4.993 0，P<0.05）。结论 将常规骨瓣开颅术与标准大骨瓣减压术应用在重型颅脑损伤治疗中均可获得一定治疗效果，但标准大骨瓣减压术的临床应用价值更显著。

[关键词] 标准大骨瓣减压术；常规骨瓣开颅术；重型颅脑损伤

[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2018）01（a）-0051-03

Comparison of Standard Large Bone Flap Decompression and Conventional Craniotomy in the Treatment of Severe Traumatic Brain Injury

LIU Qiao-bao

Department of Neurosurgery， the Third Peoples Hospital Affiliated to Fujian University of Traditional Chinese Medicine， Fuzhou， Fujian Province， 350108 China

[Abstract] Objective This paper tries to compare the clinical effect and value of conventional bone flap craniotomy and standard large bone flap decompression in the treatment of severe traumatic brain injury. Methods 102 cases of severe craniocerebral injury patients for treatment in the hospital from September 2015 to September 2017 were convenient selected as the research sample， and patients were divided into control group （n=51 cases） and experimental group （n=51 cases）， adopted the conventional craniotomy patients as the reference group， implemented the standard large trauma craniotomy patients as the experimental group， to observe the degree of nerve function defect rescue of two groups of patients with severe traumatic brain injury score， intracranial pressure， complication rate and clinical effect of surgery. Results The patients in the experimental group had a postoperatively good rate of 62.74%， neurological deficit score was（11.54±1.27） points， an intracranial pressure of （13.54±2.65）mmHg， and a complication rate of 3.92%， showing statistical significance（χ2=3.935 2，t= 22.375 6， 10.909 6， χ2=4.993 0，P<0.05）. Conclusion Conventional bone flap craniotomy and standard large bone flap decompression in the treatment of severe traumatic brain injury can obtain certain therapeutic effect， but the clinical application value of standard large bone flap decompression is more significant.

[Key words] Standard large bone flap decompression；Conventional craniotomy；Severe craniocerebral injury

重型顱脑损伤是神经外科常见的一种疾病，存在大约30%～50%的病死率，且经常与脑挫裂伤、恶性颅内压升高、脑水肿等疾病合并发生，是引发患者死亡或者致残的关键因素，临床采取保守治疗方式不能获得显著效果，救治重型颅脑损伤的关键就是开颅减压[1]，现今去骨瓣减压术得到各界人士的青睐与认可，但是常规骨瓣减压术后存在较高致残率与病死率，因此临床上亟待寻找一种有效的治疗技术。现分析该院2015年9月—2017年9月期间研究的102例重型颅脑损伤患者经不同去骨瓣减压术治疗的临床效果，报道如下。

1 资料与方法

1.1 一般资料

该次……