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1、改良外傷大骨瓣幵顱減壓術治療特重型顱腦對沖傷臨床研究［摘要］目的研宄特重型顱腦對沖傷患者采用改良外傷大骨瓣開顱減壓術治療的臨床效果。方法方便選取86例該院2013年9月一2015年9月期間收治的特重型顱腦對沖傷患者作為研究對象。按手術方式不同分為兩組，其中43例患者采用標準大骨瓣開顱減壓術治療作為對照組，另43例患者采用改良外傷大骨瓣開顱減壓術治療作為觀察組。觀兩組患者治療后顱內(nèi)壓情況、預后情況以及并發(fā)癥情況。結(jié)果兩組術前顱內(nèi)壓水平差異無統(tǒng)計學意義；觀察組術后1、3d顱內(nèi)壓水平明顯低于對照組。觀察組預后情況明顯優(yōu)于對照組。觀察組、對照組并發(fā)癥發(fā)生率分別為9.30%、27.9
2、1%，觀察組明顯較低。結(jié)論對于特重型顱腦對沖傷患者采用改良外傷大骨瓣開顱減壓術治療效果顯著，有效降低了顱內(nèi)壓水平，改善患者預后情況，并發(fā)癥少，安全性高，值得臨床推廣應用。［關鍵詞］顱腦對沖傷；大骨瓣開顱減壓術；改良外傷大骨瓣開顱減壓術；臨床療效［中圖分類號］R6［文獻標識碼］A［文章編號］1674-074205-0080-03[Abstract]ObjectiveTostudytheadoptionofModifiedTraumaLargeBoneCraniotomyDecompressioninthetreatmentofpatientswithseverecerebra
3、lhedgeinjury.Methods86casesofpatientswithseverecerebralhedgeinjuryadmittedtoourhospitalfromSeptember2013toSeptember2015wereconvenientselectiondastheresearchobject.Thepatientsweredividedintotwogroupsaccordingtodifferentsurgicalprocedures.43casesofpatientsweretreatedwithstandardlargebonecran
4、iotomydecompressionandservedasthecontrolgroup，andtheother43patientsweretreatedwithmodifiedlargetraumalargebonecraniotomyandservedastheobservationgrouptoobserveintracranialpressure,prognosisandcomplicationsofthepatientsintwogroups.ResultsTherewasnodifferencebetweenthetwogroupsinpreoperative
5、intracranialpressurewith；afterIdand3doftheoperation,thelevelsofintracranialpressureintheobservationgroupweresignificantlylowerthanthatofthecontrolgroupwith.Theprognosisoftheobservationgroupwassignificantlybetterthanthatofthecontrolgroupwith.Theincidenceofcomplicationsintheobservationgroupa
6、ndthecontrolgroupwere9.30%and27.91%respectively.Theobservationgroupwassignificantlylowerwith.ConclusionTheadoptionofmodifiedtraumalargebonecraniotomydecompressionhassignificanttherapeuticeffect，effectivelylowtheintracranialpressurelevel，andimprovepatients'prognosiswithfewcomplicationsandhi
7、ghersafetyonpatientswithseverecerebralhedgeinjurysothatifsworthyofpopularizationandapplication.[Keywords]CraniocerebralInjury；LargeBoneCraniotomyDecompression；ModifiedTraumaLargeBoneCraniotomyDecompression；ClinicalEfficacy重型顱腦對沖傷是顱腦外傷最嚴重的一種，常伴有嚴重腦挫裂傷及硬膜下血腫，致死致
