研究标准大骨瓣开颅血肿清除联合亚低温急诊治疗重型颅脑损伤的临床效果。

选取我院2014年4月至2015年1月收治的重型颅脑损伤患者50例作为研究对象，随机分为手术组(给予标准大骨瓣开颅血肿清除)和手术联合亚低温组(给予标准大骨瓣开颅血肿清除＋亚低温治疗)，分别对两组患者治疗前后颅内压、预后进行比较，预后根据格拉斯哥预后评分系统(GOS)分为患者基本恢复、患者中度残疾、患者重度残疾和患者死亡4个标准。

手术联合亚低温组和手术组患者死亡率分别占20%、32%，手术联合亚低温组显著低于手术组，治疗后两组颅内压均下降，但手术联合亚低温组下降更为显著，上述指标比较差异均有统计学意义(t＝8.98，P<0.05)。手术联合亚低温组Bederson评分为(1.48±0.34)，凋亡细胞数为(59±12)，均低于手术组的(2.79±0.28)和(116±19)，差异均有统计学意义(P均<0.05)。

标准大骨瓣开颅血肿清除治疗基础上辅以亚低温治疗重型颅脑损伤，能够迅速降低患者颅内压，改善预后，值得推广。

To study the clinical effect of standard large bone flap craniotomy combined with mild hypothermia for severe craniocerebral injury.

Fifty cases of severe craniocerebral injury patients were collected from April 2014 to January 2015 in our hospital, which were randomly divided into surgical group and combined treatment group.The patients in surgical group received standard large bone flap craniotomy for hematoma removal, and the patients in combined treatment group received standard large bone flap craniotomy plus mild hypothermia treatment.The intracranial pressure and prognosis before and after treatment in two groups were compared respectively.

The mortality of combined group and surgical group were 20% and 32%, respectively, with lowermortality of combined group group.After treatment, the intracranial pressure was decreased in two group, with more significant decrease in thecombined group(t=8.98, P<0.05). The Bederson score [(1.48±0.34)points] and apoptosis cell number (59±12) ofcombined group were lower than that of the surgical group [(2.79±0.28)pints and 116±19](t=8.765, P<0.05).

For patients with severe craniocerebral injury, standard large bone flap craniotomy combined with mild hypothermia can rapidly reduce intracranial pressure, improve the prognosis and is worthy of popularization.