控制性减压与大骨瓣减压术在重型颅脑损伤中的疗效和安全性比较

王文刚1，贾亚宁2

（陕西省扶风县人民医院：1. 神经外科；2.手术室，陕西 宝鸡，722200）

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摘要：

目的 比较控制性减压与大骨瓣减压术在重型颅脑损伤中的疗效及安全性。方法 选取本院2013年1月至2016年10月收治的80例重型颅脑损伤患者为研究对象，根据手术方法分为观察组及对照组，各40例。观察组实施控制性减压术，对照组实施标准大骨瓣减压术，比较两组患者的手术治疗效果及术后并发症发生情况。结果 术后6个月观察组患者的总有效 率为82.50%，明显高于对照组的60.00%，差异有统计学意义（P<0.05）；观察组患者术后严重低钠血症、迟发型颅内血肿、急性脑膨出及脑梗死的发生率均低于对照组，但差异无统计学意义（P>0.05）。结论 控制性减压术治疗重型颅脑损伤，患者术后并发症少，预后好，手术安全可靠。

关键词：重型颅脑损伤；控制性减压术；安全性

中图分类号：R651.15文献标志码：A文章编号：2096-1413(2017)21-0074-02

Efficacy and safety comparison of controlled decompression and large decompressive craniectomy on severe craniocerebral injury
WANG Wen-gang 1, JIA Ya-ning 2
(1. Department of Neurosurgery; 2. Operating Room, People``s Hospital of Fufeng County,
Baoji 722200, China)

ABSTRACT: Objective To compare the efficacy and safety of controlled decompression and large decompressive craniectomy in severe craniocerebral injury (SCI). Methods Eighty cases of patients with SCI in our hospital from January 2013 to October 2016 were selected as the research objects, and they were divided into control group and observation group according to the operation method, with 40 cases in each group. The control group was given large decompressive craniectomy, while the observation group was given controlled decompression. The surgical treatment effects and postoperative complications of the two groups were compared. Results After surgery for 6 months, the total effective rate of the observation group was 82.50%, which was significantly higher than 60.00% of the control group (P<0.05). The incidence rate of severe
hy ponatremia, delayed intracranial hematoma, acute encephalocele and cerebral infarction in the observation group were lower than those in the control group, but the differences were not statistically significant (P>0.05). Conclusion Controlled decompression in the treatment of SCI has less postoperative complications and good prognosis, which is safe and reliable.

KEYWORDS: severe craniocerebral injury; controlled decompression; safety

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