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时间:2017-12-07
《常规骨瓣与标准外伤大骨瓣治疗重型颅脑损伤的临床比较》由会员上传分享,免费在线阅读,更多相关内容在学术论文-天天文库。
1、微创医学2013年第8卷第6期JournalofMinimallyInvasiveMedicine,2013,8(6)·689·常规骨瓣与标准外伤大骨瓣治疗重型颅脑损伤的临床比较杨松吴海春廖光查刘海峰覃刚胡北泉兰杰(广西南宁市第一人民医院神经外科,南宁市530021)【摘要】目的比较常规骨瓣与标准外伤大骨瓣治疗重型颅脑损伤的临床效果。方法将经CT扫描证实符合诊断标准的197例重型颅脑损伤患者,分为行常规骨瓣术组101例和行标准外伤大骨瓣术组96例,对比两组术后疗效、预后和并发症情况。结果伤后6个月格拉斯哥预后评分,常规骨瓣组中预
2、后较好20例(19.8%),其中良好9例、中残11例,预后较差81例(80.2%),其中重残39例、植物生存2例、死亡40例;标准外伤大骨瓣组中预后较好31例(32.3%),其中良好19例、中残12例,预后较差65例(67.7%),其中重残31例、植物生存6例、死亡28例。两组比较差异有统计学意义(P<0.05)。标准外伤大骨瓣组切口疝、脑梗死发生率明显低于常规骨瓣对照组(P<0.05),但两组病人术后脑积水、癫痫发生率均无显著差异(P>0.05)。结论标准外伤大骨瓣治疗重型颅脑损伤较常规骨瓣临床效果好,术后切口疝、脑梗死发生率
3、相对较低。【关键词】常规骨瓣;标准外伤大骨瓣;重型颅脑损伤;临床效果【中图分类号】R651.1【文献标识码】A【文章编号】1673-6575(2013)06-0689-04ClinicalcomparisonbetweenconventionalboneflapandstandardlargetranmaboneflapinthetreatmentofseveretraumaticbraininjuryYANGSong,WUHai—chun,LIAOGuang-cha,LIUHai-feng,QmGang,HUBei—quan,
4、LAN(DepartmentofNeurosurgery,the1PeopleSHospitalofNanningCity,Nanning530021,Guangxi,R.China)【Abstract】ObjectiveTocomparetheclinicalefectbetweenconventionalboneflapandstandardlargetraumaboneflapinthetreatmentofseveretraumaticbraininjury(STBI).Method197casesofSTBIprove
5、dbyCTweredividedintotwogroups:conventionalboneflapgroupof101cases,andstandardlargetraumaboneflapgroupof96cases.ResultAccordingtoGCSof6monthsafter,theprognosiswasexceNentin20cases(amongthem,9wasnice,11wasmedium),andbadin81case(amongthem,39wasseverelydisable,2wasinplan
6、tstate,and40wasdead)intheconventionalboneflapgroup.Asforthestandardlargetraumaboneflapgroup,theprognosiswasexcellentin31cases(amongthem,19wasnice,12wasmedium),andbadin65ease(amongthem,31wasseverelydisable,6wasinplantstate,and28wasdead).Thediferencewasstatisticallysig
7、nificantbetweenthetwogroup.Incidencerateofineisionalherniaandcerebralinfarctioninstandardlargetraumaboneflapgroupwereobviouslylowerthanthoseinconventionalboneflapgroup.buttheincidencerateofhydrocephalusandepilepsyofthesetwogroupswerenotobviouslydiferent(P>0.05).Concl
8、usionsStandardlargetraumaboneflaphasbetterclinicalefectinthetreatmentofSTBI,forithasarelativelylowincidencerateofincisionalherniaan
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