标准外伤大骨瓣开颅术在重型颅脑损伤救治中的应用

Application of standard large trauma craniotomy to severe craniocerebral injury

目的探讨标准外伤大骨瓣开颅术治疗急性、亚急性硬膜下血肿等重度颅脑损伤的疗效。方法对34例急性、亚急性硬膜下血肿等重度颅脑损伤患者应用标准外伤大骨瓣开颅术治疗。结果本组34例患者术后存活23例(67．7％),死亡 11例(32．35％)。对23例存活病例根据日常生活能力分级法分为Ⅰ级11例(32．4％),Ⅱ级6例(17．7％),Ⅲ级4例(11． 8％),Ⅳ级2例(5．9％)。结论标准外伤大骨瓣开颅术能使重型颅脑损伤患者死亡率显著下降,尤其适用于广泛性额、颞、顶叶脑挫裂伤和急性硬膜下血肿伴颅内高压患者。

Objective To explore the effectiveness of standard large trauma craniotomy in severe craniocerebral injury such as acute and subacute subdural hematoma. Methods Standard large trauma craniotomy was applied to 34 patients with acute or subacute subdural hematoma. Results After operation, of 34 patients 23（67.7%） survived and 11（32.35%） died. According to daily viability, 11（32.4%） survivors were appraised as grade Ⅰ, 6（17.7%） Ⅱ, 4（11.8%） Ⅲ and 2（5.9%） Ⅳ. Conclusion Standard large trauma craniotomy makes mortality of patients with severe craniocerebral injury decrease significantly, especially suitable for patients with generalized lacerations of frontal, temple and parietal lobe accompanied with hypertention.