CAJ | 학술논문

目的：探究标准大骨瓣开颅血肿清除术治疗重型颅脑创伤侧裂区损伤的临床疗效及应用价值。方法：将2010年2月至2012年12月在该院治疗的56例重型颅脑创伤侧裂区损伤患者，分为标准组与常规组，每组各28例，分别采用标准大骨瓣开颅血肿清除术和常规大骨瓣开颅血肿清除术进行治疗，观察对比两组各项临床效果指标及预后情况。结果术后3d及7d，标准组格拉斯哥昏迷评分（GCS）明显高于常规组，但颅内压（ICP）以及中线移位情况和脑水肿体积明显低于常规组，差异均具有统计学意义（P＜0．05）；对患者进行1年随访，标准组格拉斯哥预后评分（GOS）以及生存率明显高于常规组，差异有统计学意义（P＜0．05）。结论：标准大骨瓣开颅血肿清除术治疗重型颅脑创伤侧裂区损伤临床疗效明显优于常规大骨瓣开颅血肿清除术，能够有效清除血肿，降低IC P ，并提高患者生活质量，值得临床重视与推广。
목적：탐구표준대골판개로혈종청제술치료중형로뇌창상측렬구손상적림상료효급응용개치。방법：장2010년2월지2012년12월재해원치료적56례중형로뇌창상측렬구손상환자，분위표준조여상규조，매조각28례，분별채용표준대골판개로혈종청제술화상규대골판개로혈종청제술진행치료，관찰대비량조각항림상효과지표급예후정황。결과술후3d급7d，표준조격랍사가혼미평분（GCS）명현고우상규조，단로내압（ICP）이급중선이위정황화뇌수종체적명현저우상규조，차이균구유통계학의의（P＜0．05）；대환자진행1년수방，표준조격랍사가예후평분（GOS）이급생존솔명현고우상규조，차이유통계학의의（P＜0．05）。결론：표준대골판개로혈종청제술치료중형로뇌창상측렬구손상림상료효명현우우상규대골판개로혈종청제술，능구유효청제혈종，강저IC P ，병제고환자생활질량，치득림상중시여추엄。
Objective To explore the standard large decompressive craniotomy in treatment severe traumatic brain injury lateral fissure area damage to the clinical curative effect and application value .Methods 56 patients with severe craniocerebral trauma lat-eral fissure area injury in our hospital from February 2010 to December 2012 were randomly divided into the standard group and the conventional group ,28 cases in each group ,and treated by the standard large decompressive craniotomy and routine big bone flap craniotomy hematoma removal respectively .The various index of clinical effect and prognosis were observed and compared between the two groups .Results The Glasgow coma score(GCS) on postoperative 3 ,7 d in the standard group were obviously higher than those in the conventional group ,but the intracranial pressure (ICP) ,midline shift and cerebral edema volume were significantly low-er than those in the the conventional group ,the differences had statistical significance (P< 0 .05) ,after 1 -year follow -up ,the GOS score and the survival rate in the standar group were significantly higher than those in the conventional group (P<0 .05) . Conclusion The effect of the standard large decompressive craniotomy for treating severe craniocerebral trauma lateral fissure area damage is superior to the conventional big bone flap craniotomy hematoma removal ,can effectively remove the hematoma ,reduce the intracranial pressure ,save the patient′s life and improve the quality of life ,which is worthy of clinical attention and promotion .