标准外伤大骨瓣开颅术联合高压氧救治重型颅脑损伤分析

Standard Large Traumacraniotomy Combining with Hyperbaric Oxygenation Treatment on Patients with Severe Craniocerebral Injuries

目的探讨标准外伤大骨瓣开颅术联合高压氧救治重型颅脑损伤的临床应用价值。方法随机选取2000～2006年采用标准外伤大骨瓣开颅术联合高压氧进行救治的60例重型颅脑损伤患者进行分析,伤后3个月采用格拉斯哥预后分级标准行疗效评定。结果恢复良好22例(36.6%),中残12例(20%),重残10例(16.6%),植物生存3例(5%),死亡13例(21.6%)。结论标准外伤大骨瓣开颅术联合高压氧救治重型颅脑损伤机制清楚、疗效肯定。治疗细节值得互相探讨借鉴。

Objective To evaluate the therapeutic efficacy of the method of standard large traumacraniotomy （SLT） combining with hyperbaric oxygenation（HBO） on patients with severe craniocerebral injuries. Methods Sixty patients with severe head injuries were treated from 2000 to 2006 by standard large traumacraniotomy combining with hyperbaric oxygenation treatment . Based on GOS, the clinical curative effect and complications of these patients were evaluated 3 months later after operation. Results 22 cases （36.6%） recovered well, 12 cases（20% ） suffered from moderate disability, 13 cases（21.6% ） remained severe disability and 13 cases（21.6% ） died. Conclusions The positive curative effect of SLT followed by postoperative HBO treatment early on patients with severe craniocerebral injuries is affirmable. Points of treatment should be discussed further.