CAJ | 학술논문

目的探讨改良大骨瓣开颅内外减压手术治疗重型颅脑损伤患者的临床疗效. 方法回顾性分析268例重型颅脑损伤患者的临床资料,其中应用改良大骨瓣开颅内外减压手术治疗(改良手术组)的患者152例,应用常规骨瓣开颅手术治疗(常规手术组)的患者116例,对比分析两组患者术后CT复查、颅内压监测和预后情况. 结果改良手术组术后中线基本恢复者的比例(82.2%)明显高于常规手术组(41.4%).术后颅内压(30～35 mm Hg)较常规手术组(40～60 mm Hg)明显下降,疗效(预后良好69例,预后不良56例,死亡27例)较常规手术组(预后良好40例,预后不良42例,死亡34例)更好,差异有统计学意义(P<0.05). 结论改良大骨瓣开颅内外减压手术能有效降低重型颅脑损伤患者的颅内压,减少脑组织嵌顿,改善患者的预后.
목적 탐토개량대골판개로내외감압수술치료중형로뇌손상환자적림상료효. 방법회고성분석268례중형로뇌손상환자적림상자료,기중응용개량대골판개로내외감압수술치료(개량수술조)적환자152례,응용상규골판개로수술치료(상규수술조)적환자116례,대비분석량조환자술후CT복사、로내압감측화예후정황. 결과개량수술조술후중선기본회복자적비례(82.2%)명현고우상규수술조(41.4%).술후로내압(30～35 mm Hg)교상규수술조(40～60 mm Hg)명현하강,료효(예후량호69례,예후불량56례,사망27례)교상규수술조(예후량호40례,예후불량42례,사망34례)경호,차이유통계학의의(P<0.05). 결론개량대골판개로내외감압수술능유효강저중형로뇌손상환자적로내압,감소뇌조직감돈,개선환자적예후.
Objective To explore the clinical effect of modified large trauma craniotomy (MLTC) for treatment of severe craniocerebral injury. Methods A retrospective analysis of the clinical data was conducted in 268 patients with severe craniocerebral injury receiving MLTC (n=152) or conventional craniotomy (n=116), and the results of postoperative CT, intracranial pressure monitoring and prognosis were comparatively analyzed. Results The patients undergoing MLTC showed a significantly higher recovery rate (82.2%) than those receiving conventional craniotomy (41.4%), and the intraeranial pressure was obviously lower in MLTC group (30-35 mm Hg) than in conventional craniotomy group (40-60 mm Hg). In MLTC group, 69 patients had good clinical outcomes, 56 had poor outcomes and 27 died;40 patients in the conventional craniotomy group had good clinical outcomes, 42 had poor outcomes and 34 died. Conclusion MLTC can lower the intracranial pressure, reduce incarceration of the brain tissue, and improve the prognosis of patients with severe craniocerebral injury.