贾继强

【摘要】 目的：探讨颅脑外伤患者行标准大骨瓣减压手术治疗的临床效果。方法：选取2017年4月-2019年4月本院收治的86例颅脑外伤患者，依据手术方法的不同，分为对照组与观察组，每组43例，对照组行常规开颅手术治疗，观察组行标准大骨瓣减压手术治疗。比较两组围手术期相关指标、临床疗效、术前1 d与术后30 d的格拉斯哥昏迷量表（GCS）评分。结果：观察组手术时间与住院时间均短于对照组，且术中出血量少于对照组（P<0.05）。观察组治疗总有效率高于对照组（P<0.05）;术后30 d，观察组GCS评分高于对照组（P<0.05）。结论：相较于常规开颅手术，应用标准大骨瓣减压手术治疗颅脑外伤患者的效果理想，其手术时间较短，出血量较少，患者住院时间短，同时能够提高患者术后GCS评分，值得临床推广。

【关键词】 标准大骨瓣减压手术 颅脑外伤

[Abstract] Objective： To investigate the clinical effect of standard large bone flap decompression surgery in patients with craniocerebral trauma. Method： A total of 86 patients with craniocerebral trauma admitted to our hospital from April 2017 to April 2019 were selected. According to different surgical methods， they were divided into control group and observation group， with 43 patients in each group. The control group was treated with conventional craniotomy， and the observation group was treated with standard large bone flap decompression surgery. The perioperative related indexes， clinical efficacy， Glasgow coma scale （GCS） score at 1 d before surgery and 30 d after surgery were compared between the two groups. Result： The operative time and hospital stay of the observation group were shorter than those of the control group， and the intraoperative blood loss was less than that of the control group （P<0.05）. The total effective rate of the observation group was higher than that of the control group （P<0.05）. 30 d after surgery， GCS score in the observation group was higher than that in the control group （P<0.05）. Conclusion： Compared with conventional craniotomy， the standard large bone flap decompression surgery has an ideal effect in the treatment of patients with craniocerebral trauma， with shorter operation time， less bleeding， shorter hospital stay， and improved postoperative GCS score， which is worthy of clinical promotion.

[Key words] Standard large bone flap decompression surgery Craniocerebral trauma

颅脑外伤通常是由交通事故、高空坠物，以及摔倒跌倒时的剧烈外力高能冲击导致，对患者的脑部造成开放性或闭合性的损伤，患者常表现头晕、头痛、意识模糊等症状[1]，并且这类患者的病情十分危急，发展进程快，不加以治疗干预会威胁患者的生命安全[2]。临床治疗颅脑外伤的患者，主要采取手术的手段，以降低其颅内压，清除血肿和坏死组织来到达治疗的效果。以往，采用开颅手术降低患者的颅内压，但是开放式手术，对患者的机体损伤大，手术过程中极易损伤患者正常组织，引发各种并发症。近年来，逐渐开始采用标准大骨瓣减压手术治疗，据相关报道，该术式能够显著减少手术时间，降低对患者正常组织的损伤，同时取得理想的手术效果[3-6]。为验证这一术式的确切疗效，选取本院收治的86例颅脑外伤患者，采用对比研究的方式，探究标准大骨瓣减压手术的临床疗效，现报道如下。

1 资料与方法