目的 观察控制性减压术对重型颅脑损伤患者神经功能、颅内压及预后的影响。方法 将我院2016年3月—2017年2月治疗的94例重型颅脑损伤患者作为研究对象,入选者均依据随机数表法分为两组,各47例。对照组实施大骨瓣减压术,观察组实施控制性减压术。观察手术前后两组神经功能、颅内压及预后等。结果 术前2组神经行为认知状态检查表(NCSE)评分、颅内压对比,差异无统计学意义(P＞0.05);术后观察组NCSE评分高于对照组,颅内压低于对照组,差异有统计学意义(P＜0.05);2组预后等级相比,观察组优于对照组,差异有统计学意义(P＜0.05)。结论 将控制性减压术应用于重型颅脑损伤患者中降颅内压效果良好,可恢复受损神经功能,提升患者康复效果,改善预后。

目的 探讨术中控制性减压对儿童重型颅脑损伤的治疗作用。方法 122例儿童重型颅脑损伤需要开颅手术减压患者,术中随机分成控制性减压手术研究组(60例)和常规手术治疗对照组(62例)进行治疗,观察两组患者术后脑梗死的发生率及预后。结果 研究组术后脑梗塞发生率为6.7％(4例),低于对照组的17.7％(11例)(P<0.05);术后6个月采用GOS标准进行预后判定,治疗组不良预后(重残、植物状态、死亡)有9例占15.0%,低于对照组的23例(37.1%)(P<0.05)。结论 术中采用控制性减压能减少儿童重型颅脑损伤患者术后脑梗塞的发生率及明显改善患者的预后。

Objective To investigate the clinical efficacy of intraoperative controlling decompression in treating of severe craniocerebral injuries in children. Methods 122 cases of severe craniocerebral injuries in children who needed surgical decompression by craniotomy were randomly divided into control decompression surgical group(60 cases)and conventional surgical group(62 cases).The incidence of postoperative cerebral infarction and the outcome according to GOS scores after 6 months were observed in two groups. Results The incidence of postoperative cerebral infarction was 6.7% in controlling decompression surgical group and 17.7% in conventional surgical group. The differences between two groups were statistical significant(P<0.05); The all poor prognosis patients(severely disabled, vegetative state and death) were 9 cases in controlling decompression surgical group and 23 cases in conventional surgical group. The differences between two groups were statistical significant(P<0.05). Conclusion Intraoperative controlling decompression can significantly reduced the incidence of postoperative cerebral infarction and improved the poor prognosis patients of severe craniocerebral injuries in children.