控制性阶梯式减压术对颅脑损伤患者预后及并发症的影响研究(1)
摘要：目的 探讨控制性阶梯式减压术在颅脑损伤中的效果及对患者预后、并发症的影响。方法 选择2016年4月～2017年11月我院收治的颅脑损伤患者72例，随机分为对照组和观察组，各36例。对照组采用标准大骨瓣快速减压术治疗，观察组采用控制性阶梯式减压术治疗，比较两组治疗预后及并发症发生率。结果 观察组良好、中度残疾率均高于对照组，差异有统计学意义(P<0.05);观察组重度残疾、植物生存及死亡率均低于对照组，差异有统计学意义(P<0.05);观察组并发症发生率低于对照组，但差异无统计学意义(P>0.05)。结论 控制性阶梯式减压术治疗颅脑损伤患者，可有效改善患者预后，不增加并发症发生率，值得应用。
关键词：控制性阶梯式减压术;标准大骨瓣快速减压术;颅脑损伤;预后;并发症
中图分类号：R651.15 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.07.032
, 百拇医药
文章编号：1006-1959(2019)07-0110-02
Abstract：Objective To investigate the effect of controlled step decompression in craniocerebral injury and its influence on prognosis and complications. Methods 72 patients with craniocerebral injury admitted to our hospital from April 2016 to November 2017 were randomly divided into control group and observation group， 36 cases each. The control group was treated with standard large bone flap decompression， and the observation group was treated with controlled step decompression. The prognosis and complication rate of the two groups were compared. Results The good and moderate disability rate of the observation group were higher than that of the control group (P<0.05). The severe disability， plant survival and mortality of the observation group were lower than the control group after treatment. The difference was statistically significant(P<0.05); the incidence of complications in the observation group was lower than that in the control group， but the difference was not statistically significant (P>0.05). Conclusion Controlled step decompression for patients with craniocerebral injury can effectively improve the prognosis of patients without increasing the incidence of complications， which is worthy of application.
, http://www.100md.com
Key words：Controlled step decompression;Standard large bone flap decompression;Craniocerebral injury;Prognosis;Complications
顱脑损伤(craniocerebral injury)属于发生率较高的外伤，既可单独存在，亦可与其他损伤复合存在，常见原因包括高处坠落、工伤事故、交通事故等[1]，临床表现为头痛、呕吐、意识障碍及瞳孔变化等，影响患者健康、生活。标准大骨瓣快速减压术是颅脑损伤患者中常用的手术治疗方法，虽然能改善患者症状，但是远期治疗预后较差，术后并发症发生率较高[2]。控制性阶梯式减压术能减缓迟发血肿的发生，有助于减轻缺血再灌注损伤，能较好的控制急性脑膨出、术后梗死。因此，本研究探讨控制性阶梯式减压术在颅脑损伤中的效果及对预后、并发症的影响，报道如下。
1资料与方法
1.1一般资料 选择佳木斯市中心医院2016年4月～2017年11月治疗的颅脑损伤患者72例作为研究对象。本研究经佳木斯市中心医院伦理委员会批准通过，所有患者及家属均签署知情同意书。采用随机数字表法将患者分为对照组和观察组，各36例。对照组中男21例，女15例，年龄14～83岁，平均年龄(56.83±5.79)岁;格拉斯哥昏迷评分3～8分，平均评分(4.61±0.65)分。损伤原因：车祸伤15例，跌倒伤14例，头部打击伤7例。观察组中男20例，女16例，年龄13～85岁，平均年龄(57.29±5.81)岁;格拉斯哥昏迷评分3～8分，平均评分(4.52±0.61)分。损伤原因：车祸伤14例，跌倒伤16例，头部打击伤6例。两组患者性别、年龄等一般资料对比，差异无统计学意义(P>0.05)，具有可比性。, 百拇医药(王春城)
关键词：控制性阶梯式减压术;标准大骨瓣快速减压术;颅脑损伤;预后;并发症
中图分类号：R651.15 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.07.032
, 百拇医药
文章编号：1006-1959(2019)07-0110-02
Abstract：Objective To investigate the effect of controlled step decompression in craniocerebral injury and its influence on prognosis and complications. Methods 72 patients with craniocerebral injury admitted to our hospital from April 2016 to November 2017 were randomly divided into control group and observation group， 36 cases each. The control group was treated with standard large bone flap decompression， and the observation group was treated with controlled step decompression. The prognosis and complication rate of the two groups were compared. Results The good and moderate disability rate of the observation group were higher than that of the control group (P<0.05). The severe disability， plant survival and mortality of the observation group were lower than the control group after treatment. The difference was statistically significant(P<0.05); the incidence of complications in the observation group was lower than that in the control group， but the difference was not statistically significant (P>0.05). Conclusion Controlled step decompression for patients with craniocerebral injury can effectively improve the prognosis of patients without increasing the incidence of complications， which is worthy of application.
, http://www.100md.com
Key words：Controlled step decompression;Standard large bone flap decompression;Craniocerebral injury;Prognosis;Complications
顱脑损伤(craniocerebral injury)属于发生率较高的外伤，既可单独存在，亦可与其他损伤复合存在，常见原因包括高处坠落、工伤事故、交通事故等[1]，临床表现为头痛、呕吐、意识障碍及瞳孔变化等，影响患者健康、生活。标准大骨瓣快速减压术是颅脑损伤患者中常用的手术治疗方法，虽然能改善患者症状，但是远期治疗预后较差，术后并发症发生率较高[2]。控制性阶梯式减压术能减缓迟发血肿的发生，有助于减轻缺血再灌注损伤，能较好的控制急性脑膨出、术后梗死。因此，本研究探讨控制性阶梯式减压术在颅脑损伤中的效果及对预后、并发症的影响，报道如下。
1资料与方法
1.1一般资料 选择佳木斯市中心医院2016年4月～2017年11月治疗的颅脑损伤患者72例作为研究对象。本研究经佳木斯市中心医院伦理委员会批准通过，所有患者及家属均签署知情同意书。采用随机数字表法将患者分为对照组和观察组，各36例。对照组中男21例，女15例，年龄14～83岁，平均年龄(56.83±5.79)岁;格拉斯哥昏迷评分3～8分，平均评分(4.61±0.65)分。损伤原因：车祸伤15例，跌倒伤14例，头部打击伤7例。观察组中男20例，女16例，年龄13～85岁，平均年龄(57.29±5.81)岁;格拉斯哥昏迷评分3～8分，平均评分(4.52±0.61)分。损伤原因：车祸伤14例，跌倒伤16例，头部打击伤6例。两组患者性别、年龄等一般资料对比，差异无统计学意义(P>0.05)，具有可比性。, 百拇医药(王春城)