目的 探讨标准大骨瓣减压术治疗重型创伤性脑损伤的临床疗效.方法 126例重型创伤性脑损伤患者按照入院顺序分为两组,其中76例接受标准大骨瓣减压术(标准大骨瓣组),50例接受常规骨瓣减压术(常规骨瓣组);术后连续7 d 观察两组患者的颅内压,术后6个月进行GOS 评分.结果 标准大骨瓣组患者术后第1、2、7 天颅内压明显低于常规骨瓣组患者,二者比较差异有统计学意义(P < 0.05);标准大骨瓣组患者GOS 评分优良(良好+中残)率为71.1%,显著高于常规骨瓣组的48.0%,二者比较差异有统计学意义(P < 0.05).结论 采用标准大骨瓣减压术可有效降低重型创伤性脑损伤患者的颅高压、病死率和致残率,提高治疗效果.%Objective To explore clinical curative effect of standard decompression with large craniectomy for severe traumatic brain iniury. Methods 126 patients of severe traumatic brain injury were divided into two groups according to the hospital order, 76 patients accepted standard decompression with large craniectomy, 50 patients accepted routine craniectomy. For 7 days after surgery, the intracranial pressure and after 6 months the GOS scores were detected. Results The in-tracranial pressure of the postoperative 1, 2 and 7 days of standard decompression with large craniectomy group was significantly lower than the routine craniectomy group (P < 0.05). The excellent rate (good and residual} for GOS score of large craniectomy group (71.1%) was significantly higher than routine craniectomy group (48.0%) (P < 0.05). Conclusion The standard decompression with large craniectomy can reduce the intracranial pressure of severe traumatic brain injury, and reduce mortality and morbidity of severe brain injury.
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