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目的探讨经常规骨瓣开颅术与标准大骨瓣减压术在重型颅脑损伤中的应用价值。方法选取我院在2012年3月至2015年1月间收治的82例重型颅脑损伤患者的临床资料,将患者随机分为两组,每组41例。对照组给予常规骨瓣开颅术治疗,观察组采用标准大骨瓣减压术治疗,比较两组患者的颅内压改善情况与并发症发生率。结果 (1)观察组术后的颅内压改善效果优于对照组,对比有统计学意义(P<0.05)。(2)观察组的切口疝、颅内感染、术后再出血发生率为:4.88%、2.44%、7.32%,对照组为:17.07%、4.88%、19.51%,观察组的切口疝、术后再出血发生率与对照组相比有统计学意义(P<0.05)。结论重型颅脑损伤患者经标准大骨瓣减压术治疗,可促使颅内压得以改善,降低术后再出血发生率,值得临床推广应用。
Objective To investigate the value of conventional craniotomy and standard decompressive craniectomy in severe craniocerebral injury. Methods The clinical data of 82 severe craniocerebral injury patients from March 2012 to January 2015 in our hospital were selected and randomly divided into two groups (41 in each group). The control group was given conventional craniotomy. The observation group was treated with standard decompressive craniectomy. The improvement of intracranial pressure and complication rate were compared between the two groups. Results (1) The improvement of intracranial pressure in the observation group was better than that in the control group, with statistical significance (P <0.05). (2) The incidences of incisional hernia, intracranial infection and postoperative hemorrhage were 4.88%, 2.44% and 7.32% in the observation group and 17.07%, 4.88% and 19.51% in the control group. Incisional hernia in the observation group The incidence of rebleeding was statistically significant compared with the control group (P <0.05). Conclusions The treatment of severe craniocerebral injury with standard decompressive craniectomy can promote the improvement of intracranial pressure and reduce the incidence of postoperative hemorrhage. It is worthy of clinical application.