CAJ | 학술논문

目的：综合性研究分析重型颅脑损伤患者临床治疗的有效性和安全性。方法选取本院87例重型颅脑损伤患者，以随机数表法将其分为观察组（44例）和对照组（43例）。观察组患者采取标准外伤大骨瓣减压术联合腰大池持续引流术治疗，对照组患者采用腰大池持续引流术治疗。对比两组患者格拉斯哥预后评分（GOS）、术后并发症发生情况及死亡率。结果观察组患者GOS评分恢复良好33例（75%），显著高于对照组[23例（53.49%）]，差异具有显著性（P＜0.05）；观察组重度残疾2例（4.55%）、植物生存1例（2.27%），显著低于对照组[8例（18.60%），6例（13.95%）]，差异均有显著性（P均＜0.05）；观察组脑血管痉挛8例（18.18%）、肺部感染2例（4.55%）、营养不良2例（4.55%），均显著低于对照组[17例（39.53%）、8例（18.60%）、9例（20.93%）]，差异均有显著性（P均＜0.05）；治疗3周后对照组患9例（20.93%）死亡，显著高于观察组[2例（4.55%）]，差异具有显著性（P＜0.05），而两组患者在轻度残疾情况和泌尿系统感染方面比较差异均无显著性（P均＞0.05）。结论重型颅脑损伤患者经标准外伤大骨瓣减压术联合腰大池持续引流术治疗后，GOS评分恢复良好者增多，并发症发生率和死亡率显著降低，安全、有效，值得临床推广应用。
목적：종합성연구분석중형로뇌손상환자림상치료적유효성화안전성。방법선취본원87례중형로뇌손상환자，이수궤수표법장기분위관찰조（44례）화대조조（43례）。관찰조환자채취표준외상대골판감압술연합요대지지속인류술치료，대조조환자채용요대지지속인류술치료。대비량조환자격랍사가예후평분（GOS）、술후병발증발생정황급사망솔。결과관찰조환자GOS평분회복량호33례（75%），현저고우대조조[23례（53.49%）]，차이구유현저성（P＜0.05）；관찰조중도잔질2례（4.55%）、식물생존1례（2.27%），현저저우대조조[8례（18.60%），6례（13.95%）]，차이균유현저성（P균＜0.05）；관찰조뇌혈관경련8례（18.18%）、폐부감염2례（4.55%）、영양불량2례（4.55%），균현저저우대조조[17례（39.53%）、8례（18.60%）、9례（20.93%）]，차이균유현저성（P균＜0.05）；치료3주후대조조환9례（20.93%）사망，현저고우관찰조[2례（4.55%）]，차이구유현저성（P＜0.05），이량조환자재경도잔질정황화비뇨계통감염방면비교차이균무현저성（P균＞0.05）。결론중형로뇌손상환자경표준외상대골판감압술연합요대지지속인류술치료후，GOS평분회복량호자증다，병발증발생솔화사망솔현저강저，안전、유효，치득림상추엄응용。
ObjectiveTo study comprehensive analysis of the efifcacy and safety the clinical treatment of severe head injury.Method87 cases of patients were diagnosed with severe head injury, with digital method randomly divided into observation group (44 cases) and control group (43 cases). Patients in observation group were treated by large trauma craniectomy combined comtinuous lumbar cistren drainage, control group were treated by continuous lumbar cistern drainage. Compared two groups of patients with GOS score, postoperative complications, mortality.ResultObservation group GOS prognostic score good recovery of 33 cases (75.00%) was signiifcantly higher than control group [23 cases (53.49%)]. Observation group at the same time of severe disability was 2 cases (4.55%), plant survival was 1 cases (2.27%) were signiifcantly lower than control group [8 cases (18.60%), 6 cases (13.95%)]. There were statistically signiifcant differences (Pal<0.05). Cerebral vasospasm group accounted for 8 cases (18.18%), pulmonary infection (4.55%), malnutrition (4.55%) were signiifcantly less than control group. There were statistically signiifcant differences (Pal<0.05). After 3 weeks of treatment, control group a total of 9 cases (20.93%) were death, signiifcantly more than observation group [2 cases (4.55%)], the difference was signiifcant (P<0.05), two groups of patients in the mild disability and urinary tract infections had no exist signiifcant difference (P>0.05).ConclusionAfter the treatment of large trauma craniectomy combined continuous lumbar cistern drainage for severe craniocerebral injury patients, prognostic effect is significant, the incidence of complications is reduce significantly, the comprehensive treatment is safe and effective, worthy of recommendation.