CAJ | 학술논문

目的：探讨双侧平衡去骨瓣减压术治疗重型闭合性颅脑损伤的临床效果。方法将118例重型闭合性颅脑损伤患者随机分为两组，各59例。双侧组采用双侧平衡去骨瓣减压术治疗，单侧组采用标准去骨瓣减压术治疗。比较两组颅内压、生存质量及并发症发生情况。结果双侧组术后1 d颅内压低于治疗前（ P ＜0．01），术后3 d颅内压低于术后1 d（ P ＜0．01）；单侧组术后1 d颅内压低于治疗前（ P ＜0．01），术后3 d颅内压低于术后1 d（ P ＜0．01）；双侧组术后1 d及术后3 d颅内压下降幅度均大于单侧组（ P ＜0．01）。双侧组恢复良好率为35．59％，高于单侧组的16．95％（ P ＜0．05）；双侧组病死率为5．08％，低于单侧组的22．03％（ P ＜0．01）；双侧组并发症发生率低于单侧组（ P ＜0．05）。结论双侧平衡去骨瓣减压术治疗重型闭合性颅脑损伤效果显著，可快速降低颅内压，提高术后生存质量，且并发症发生率降低，有较高的安全性。
목적：탐토쌍측평형거골판감압술치료중형폐합성로뇌손상적림상효과。방법장118례중형폐합성로뇌손상환자수궤분위량조，각59례。쌍측조채용쌍측평형거골판감압술치료，단측조채용표준거골판감압술치료。비교량조로내압、생존질량급병발증발생정황。결과쌍측조술후1 d로내압저우치료전（ P ＜0．01），술후3 d로내압저우술후1 d（ P ＜0．01）；단측조술후1 d로내압저우치료전（ P ＜0．01），술후3 d로내압저우술후1 d（ P ＜0．01）；쌍측조술후1 d급술후3 d로내압하강폭도균대우단측조（ P ＜0．01）。쌍측조회복량호솔위35．59％，고우단측조적16．95％（ P ＜0．05）；쌍측조병사솔위5．08％，저우단측조적22．03％（ P ＜0．01）；쌍측조병발증발생솔저우단측조（ P ＜0．05）。결론쌍측평형거골판감압술치료중형폐합성로뇌손상효과현저，가쾌속강저로내압，제고술후생존질량，차병발증발생솔강저，유교고적안전성。
Objective To investigate the clinical efficacy of treatment of balanced bilateral decompressive craniectomy in treatment of severe closed head injury.Methods One hundred and eighteen cases of severe closed head injury were selected and di-vided into two groups( n =59 in each group) ,and the bilateral group was treated with balanced bilateral decompressive craniectomy and the unilateral group was treated with the standard decompressive craniectomy.Intracranial pressure,quality of life and complica-tions of the two groups were compared.Results The intracranial pressure of the bilateral group on d 1 after surgery was lower than that before treatment( P <0.01)and it was lower on d 3 than on 1 d( P <0.01).The drop of pressure of the bilateral group on 1 d and 3 d was bigger than that of the unilateral group( P <0.01).The good recovery rate of the bilateral group (35.59%) was higher than 16.95%of the unilateral group( P <0.05).The mortality rate of the bilateral group(5.08%) was lower that (22.03%)of the unilat-eral group( P <0.05), but the complications incidence rate was lower than that of the unilateral group( P <0.05).Conclusion The balanced bilateral decompressive craniectomy in treatment of severe closed head injury has good efficacy and can quickly reduce in -tracranial pressure and lower incidence rate of complications and improve the postoperative quality of life.