重型颅脑损伤患者采用高压氧联合标准脑外伤大骨瓣开颅减压术的疗效观察

蔡舒

（南通大学附属海安人民医院神经外科，江苏 南通，226600）

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摘要：

目的 探讨对重型颅脑损伤患者采用高压氧联合标准脑外伤大骨瓣开颅减压手术的临床疗效。方法 选取我院因重度颅脑损伤（GCS≤8 分）行手术治疗的患者120 例，按照随机分配的原则分为对照组和观察组。其中60例采用标准脑外伤大 骨瓣减压手术配合常规治疗的患者作为对照组，另外60例在对照组基础上联合高压氧治疗的患者作为观察组，比较两组患者的临床疗效。结果 两组患者治疗前的GCS评分无明显差异（P>0.05）；两组患者治疗后的GCS评分均较治疗前升高，且观 察组的GCS 评分高于对照组（P<0.05）。随访结果显示，观察组患者的GOS评分明显高于对照组，同时预后良好率明显优于 对照组患者（P<0.05）。结论 标准脑外伤大骨瓣开颅手术的同时联合高压氧治疗，对于降低重型颅脑损伤的重残率、死亡率，提高患者的生存质量具有积极的意义，可在临床治疗中推广使用。

关键词：重型颅脑损伤；高压氧；标准脑外伤大骨瓣减压手术；预后

中图分类号：R651.15文献标志码：A文章编号：2096-1413(2017)32-0054-03

Clinical effect of hyperbaric oxygen combined with standard large trauma craniotomy on severe traumatic brain injury
CAI Shu
(Department of Neurosurgery, Hai``an People``s Hospital, the Affiliated Hospital of Nantong University, Nantong 226600, China)

ABSTRACT: Objective To explore the effects of hyperbaric oxygen combined with standard large trauma craniotomy on severe traumatic brain injury. Methods A total of 120 patients with severe traumatic brain injury (GCS≤8) in our hospital were selected and randomly divided into observation group and control group. The 60 cases received normal treatment and standard large trauma craniotomy were selected as the control group; on this basis, 60 cases added hyperbaric oxygen were selected as the observation group. The clinical efficacy of the two groups were compared. Results There was no significant difference in the GCS scores between the two groups before treatment (P>0.05); after treatment, the GCS scores of the two groups were higher than those before treatment, and the GCS score of the observation group was higher than that of the control group (P<0.05). Follow-up results showed that the GOS score of the observation group was significantly higher than that of the control group, and the favorable prognosis rate in the observation group was significantly better than that in the control group (P<0.05). Conclusion Hyperbaric oxygen combined with standard large trauma craniotomy has positive significance on reducing severe disability, mortality, improving the patients`` quality of life in patients with severe traumatic brain injury, which can be used in clinical treatment.
KEYWORDS: severe traumatic brain injury; hyperbaric oxygen; standard large trauma craniotomy; prognosis

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