目的：探讨硬脑膜严密扩大缝合对特重型颅脑损伤开颅去骨瓣减压患者的效果分析。方法回顾性分析2013年1月—2015年1月该院收住的102例特重型颅脑损伤患者单侧标准外伤大骨瓣减压后随机分组行硬脑膜严密扩大缝合(研究组52例)和敞开硬脑膜(对照组50例)患者的临床资料，比较两组术后头皮切口脑脊液漏发生率、癫痫发生率以及伤后1年的格拉斯哥预后评分(GOS)等参数。结果研究组、对照组术后头皮切口脑脊液漏发生率分别为1.9%(1/52)和12%(6/50)(P﹤0.05)。研究组、对照组生存患者晚期癫痫发生率分别为34.1%(14/41)和57.5%(23/40)(P﹤0.05)。研究组、对照组有效治疗率分别为38.5%(20/52)和20%(10/50)(P﹤0.05)。研究组、对照组病死率分别为21.2%(11/52)和20%(10/50)(P﹥0.05)，差异均有统计学意义。结论采用硬脑膜严密扩大缝合能降低特重型颅脑损伤去骨瓣减压患者头皮切口漏发生率、晚期癫痫发生率，提高治疗有效率。%Objective To investigate the clinical effects of tension suture of dura-mater after decompressive craniectomy in severe craniocerebral trauma. Methods The study retrospectively analyzed severe craniocerebral trauma patients managed with standard decompressive craniectomy in the presence(study group,n=52)or absence of dura-mater close(control group,n=50) randomly from January 2013 to January 2015 in our hospital,clinical data, such as incision leakage of cerebrospinal fluid,morbidity of epilepsy,Glasgow Outcome Scale(GOS)12 months after injury. Results The incidence of incision leakage of cerebrospinal fluid was 1.9%(1/52) in study group and 12%(6/50)in control group (P﹤0.05). late epilepsy ratio among the survivor was 34.1%(14/41) in study group and 57.5%(23/40)in control group(P﹤0.05). the clinical efficacy was 38.5%(20/52) in study group and 20%(10/50)in control group (P﹤0.05). the mortality rate was 21.2%(11/52) in study group and 20%(10/50) in control group (P>0.05),the difference was statistically significant. Conclusion To close the dura-mater by tension-reduced suture following decompressive craniectomy of severe craniocerebral trauma reduce incision leakage of cerebrospinal fluid,morbidity of epilepsy and improves the clinical efficacy.
展开▼
