联合内外减压术治疗重度颅脑损伤合并脑疝的临床观察

周斌

陕西省商洛市山阳县人民医院，陕西 商洛，726400

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摘要：

目的 分析联合内外减压术治疗重度颅脑损伤合并脑疝的临床效果。方法 将我院 2014年 3月至 2015年 3月收治的 86例重度颅脑损伤合并脑疝患者随机分为观察组（采用去骨瓣减压术+血肿清除术+联合内外减压术治疗，n=43）与对照组（采用去骨瓣减压术+血肿清除术治疗，n=43），比较两组临床效果。结果 两组术后 3、7 d颅内压均低于术后 1 d，术后 7 d低于术后 3 d（P<0.05），且观察组术后 1、3、7 d颅内压低于对照组（P<0.05）。观察组术后并发症总发生率为 11.63% ，显著低于对照组的 30.23%（P<0.05），6个月随访 GOS预后良好率略高于对照组（P>0.05），死亡率低于对照组（P<0.05）。结论 联合内外减压术可有效降低颅脑重创合并脑疝患者的颅内压，降低术后并发症发生率。

关键词： 联合内外减压术；重度颅脑损伤联合脑疝；颅内压

中图分类号： R651.15文献标志码：A文章编号：2096-1413(2018)09-0068-02

Clinical observation of combined internal and external decompression in the
treatment of severe craniocerebral injury complicated with cerebral hernia
 

ZHOU Bin
(thePeople'sHospitalofShanyangCounty,Shangluo726400,China)



ABSTRACT: Objective To study the clinical effect of combined internal and external decompression in the treatment of severe craniocerebral injury complicated with cerebral hernia. Methods A total of 86 patients with severe craniocerebral injury complicated with cerebral hernia admitted in our hospital from March 2014 to March 2015 were randomly divided into obser vation group (given decompressive craniectomy+evacuation ofhematoma+combined internal and externalde compression ,n=43)and control group (given decompressive craniectomy +evacuation of hematoma, n=43).The clinical effects were compared between the two groups.Results The intracranial pressure at3,7 d after operation in both groups were significantly lower than those at 1 d after operation, and that at 7d after operation was lower than at 3 d after operation (P<0.05).The intracranial pressure of the observation group at 1,3,7d after operation were lower than those of the control group (P<0.05).The total incidence of post operative complications in the observation group was 11.63% ,which was significantly lower than 30.23% in the control group (P<0.05).The good rate of GOS prognosis in the observation group was slightly higher than that in the control group during6 months of follow-up (P>0.05),the mortality rate was lower than that in the control group (P＜0.05). Conclusion Combined internal and external decompression can effectively decrease the intracranial pressure of patients with severe craniocerebral injury complicated with cerebral hernia,and decrease the incidence of postoperative complications.
KEYWORDS: combined internal and external decompression; severe craniocerebral injury complicated with cerebral hernia; intracranial pressure
 

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