摘要目的 探讨标准大骨瓣减压术在重型颅脑损伤中的应用效果.方法 回顾性分析2016年1月至2018年2月长治医学院附属和济医院治疗的114例重型颅脑损伤患者的临床资料,根据手术方案将其分为对照组(常规骨瓣开颅术,57例)与观察组(标准大骨瓣减压术,57例),比较两组患者手术前后颅内压、脑功能障碍程度评分(DRS评分)、髓鞘碱性蛋白(MBP)、前白蛋白(PA).结果 术前,两组患者颅内压、DRS评分、MBP、PA水平比较,差异未见统计学意义(P>0.05);术后各时间段,观察组患者颅内压均低于对照组,差异有统计学意义(P<0.05);术后3 d,观察组患者DRS评分低于对照组,MBP水平低于对照组,PA水平高于对照组,差异有统计学意义(P<0.05).结论 重型颅脑损伤患者通过标准大骨瓣减压术治疗,可有效控制颅内压,改善脑功能,利于调节MBP、PA水平.

abstractsObjective To evaluate the effect of decompressive craniotomy with standard large bone flap in the treatment of severe craniocerebral injury .Methods The clinical data of 114 patients with severe craniocerebral injury treated in Changzhi Medical College Affiliated Heji Hospital from January 2016 to February 2018 were retrospectively analyzed .They were divided into control group ( routine craniotomy , 57 cases ) and observation group ( standard large craniotomy , 57 cases ) . Intracranial pressure, brain function, myelin basic protein (MBP) and prealbumin (PA) were compared between the two groups .Results There was no significant difference in intracranial pressure , disability rating scale (DRS) score, MBP and PA level between the two groups before operation (P>0.05);intracranial pressure in the observation group was lower than that in the control group at all time points after operation ( P<0.05 ) .DRS score in the observation group was lower than that in the control group , MBP level was lower than that in the control group , and PA level was higher than that in the control group 3 days after operation ( P<0.05 ) .Conclusions The patients with severe craniocerebral injury treated by decompressive craniotomy with standard large bone flap can effectively control intracranial pressure , improve brain function and regulate the levels of MBP and PA .