探讨重症颅脑外伤患者开颅手术的临床效果观察.docVIP

精品论文 参考文献 探讨重症颅脑外伤患者开颅手术的临床效果观察 望奎县人民医院 152100 摘要：目的 探讨并研究开颅手术治疗重症颅脑外伤患者的临床疗效。方法 此次研究的对象是选取2009年4月～2012年10月来本院接受治疗的60例重型颅脑外伤患者，将其临床资料进行回顾性分析，并实施大骨瓣开颅手术进行治疗，观察并比较手术前后患者格拉斯哥昏迷评分（GCS），同时对手术临床疗效及并发症发生情况进行评价。结果 治疗前患者GCS为（5.42plusmn;1.44）分，治疗后为（12.57plusmn;3.75）分，治疗前后GCS差异有统计学意义（Plt;0.05）；术后患者存活率达90.0%（54/60）；手术后患者发生脑积水7例，脑脊液外漏4例，脑膨出3例，其他并发症1例。结论 大骨瓣开颅手术治疗重症颅脑外伤，临床疗效显著，可大大提高患者的存活率，降低并发症发生率，是临床治疗重症颅脑外伤较理想的方法，值得推广应用。 关键词：重症颅脑外伤；开颅手术；临床分析 [Abstract] Objective To investigate and study the clinical effect of craniotomy in the treatment of patients with severe craniocerebral trauma. Methods the study object is the selection of 2009 April to October 2012 to the hospital to accept the treatment of 60 cases of severe craniocerebral trauma patients，the clinical data were retrospective analysis，and implementation of large bone flap craniotomy treatment，were observed and compared before and after operation in patients with Glasgow Coma Score（GCS），also on clinical efficacy and complications occurrence was evaluated. Results in the treatment of patients with GCS as（5.42 + 1.44），after treatment for（12.57 + 3.75）and of Glasgow Coma Scale（GCS）before and after treatment，the difference has statistical significance（P lt; 0.05）；postoperative survival rate was 90.0%（52 / 60）；after surgery in patients with hydrocephalus occurred in 7 cases，cerebrospinal fluid leakage in 4 cases，encephalocele in 3 cases，other complication 1 case. Conclusion large bone flap craniotomy surgery for the treatment of severe craniocerebral trauma，clinical curative effect is significant，can greatly improve the patients survival rate and reduce the incidence of complications，clinical treatment of severe craniocerebral trauma is a ideal method，it is worth popularization and application. Severe traumatic brain injury；craniotomy；clinical analysis 脑震荡、颅骨骨折、颅内出血以及头皮损伤等均称为颅脑外伤，是由直接或间接的外界暴力原因（高空坠落、车祸、碰撞等）造成的头部损伤的总称[1]，其主要临床表现有意识模糊、混乱、恶心呕吐、头昏、头痛、神经功能缺损等[2]。因为重症颅脑外伤具有发病急、病情严重等特点，因此，其死亡率和致残率极高，严重危害了患者的生命安全[3]。目前，治疗重症