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《腦膜補(bǔ)片聯(lián)合大骨瓣減壓術(shù)治療重度顱腦損傷的臨床效果.doc》由會(huì)員上傳分享，免費(fèi)在線閱讀，更多相關(guān)內(nèi)容在工程資料-天天文庫(kù)。
1、腦膜補(bǔ)片聯(lián)合大骨瓣減壓術(shù)治療重度顱腦損傷的臨床效果朱福彬廖振華等【論文摘要】目的探討腦膜補(bǔ)片聯(lián)合大骨瓣減壓術(shù)治療重度顱腦損傷的臨床效果。方法選取2013年12月?2015年2月到我院就診的88例重度顱腦損傷患者，按照隨機(jī)數(shù)字表法將其分為觀察組和對(duì)照組，每組44例。對(duì)照組采取大骨瓣減壓術(shù)治療，觀察組在此基礎(chǔ)上聯(lián)合腦膜補(bǔ)片治療，比較兩組的治療效果。結(jié)果觀察組預(yù)后良好率為59.1%,高于對(duì)照組的25.0%；死亡率為9.1%,低于對(duì)照組的29.6%；兩組差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。兩組的NIHSS評(píng)分均低于治療前，且觀察組的NIHSS評(píng)分低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義(P<0
2、.05)o觀察組術(shù)后腦膨出、腦積水、顱內(nèi)感染、腦脊液漏的發(fā)生率低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義(P<0.05)o結(jié)論腦膜補(bǔ)片聯(lián)合大骨瓣減壓術(shù)治療重度顱腦損傷的效果顯著，臨床價(jià)值高?！菊撐年P(guān)鍵詞】重度顱腦損傷；腦膜補(bǔ)片；大骨瓣減壓術(shù)Clinicaleffectofdurapatchcombinedwithlargeboneflapdecompressioninthetreatmentofseverecraniocerebraltrauma[Abstract]ObjectiveToinvestigatetheclinicaleffectofdurapatchcombinedwit
3、hlargeboneflapdecompressioninthetreatmentofseverecraniocerebraltrauma.Methods88patientswithseverecraniocerebraltraumaadmittedintoourhospitalfromDecember2013toFebruary2015wereselected.Theyweredividedintoobservationgroupandcontrolgroupaccordingtotherandomnumbertablemethod,with44casesineachg
4、roup.Thecontrolgroupwastreatedwithlargeboneflapdecompression,theobservationgroupwastreatedwithduralpatchonthebasicofcontrolgroup.Thetherapeuticeffectintwogroupswascompared.ResultsThegoodprognosisrateinobservationgroupwas59.1%,whichwassignifleantlyhigherthan25.0%ofcontrolgroup,andmortality
5、ratewas9.1%,whichwaslowerthan29.6%ofcontrolgroup.Thedifferencesbetweentwogroupsweresignificant(P<0.05).NIHSSscoreintwogroupswaslowerthanthebeforetreatment,andNIHSSscoreinobservationgroupwaslowerthanthecontrolgroup(P<0.05).Theincidencerateofencephalocele,hydrocephalus,intracranialinfection
6、,cerebrospinalfluidleakageinobservationgroupwerelowerthanthoseofthecontrolgroup.Thedifferenceswerestatisticallysignificance(P<0.05).ConclusionDurapatchcombinedwithlargeboneflapdecompressioninthetreatmentofseverecraniocerebraltraumaiseffectiveandclinicalvalueishigh.[Keywords]Severecranioce
7、rebraltrauma；Duralpatch；Largeboneflapdecompression標(biāo)準(zhǔn)大骨瓣減壓術(shù)是臨床常用的急性顱內(nèi)血腫清除術(shù)，對(duì)重型顱腦損傷或合并腦疝、廣泛硬膜下血腫、腦挫裂傷、腦水腫等疾病起到顯著的治療效果[l]o重度顱腦損傷(顱骨和硬腦膜缺損等)患者行大骨瓣減壓術(shù)后，易出現(xiàn)腦膨出等癥狀，對(duì)患者術(shù)后神經(jīng)功能恢復(fù)及預(yù)后質(zhì)量產(chǎn)生嚴(yán)重影響[2],因此對(duì)重度顱腦損傷患者采取大骨瓣減壓術(shù)治療時(shí)，聯(lián)合腦膜補(bǔ)片修補(bǔ)可促進(jìn)患者術(shù)后康復(fù)。本研究以44例重度顱腦損傷患者作為研究對(duì)象，采取腦膜補(bǔ)片聯(lián)合大骨瓣減壓術(shù)進(jìn)行治療，取
