重型颅脑创伤治疗中颅骨去骨瓣减压术的应用及注意事项

Application and key points of decompressive craniectomy in the treatment of severe head injury

重型颅脑创伤后发生严重的脑水肿、肿胀,在药物不能控制时,应及时行颅骨去骨瓣减压术(DC)。DC可降低颅内压力、改善脑血液循环和代谢、解除脑疝、挽救病人生命,并为其他治疗奠定了基础。本文就DC的作用机制、适应证、手术要点和并发症防治进行探讨,以降低重型颅脑创伤的死亡率和伤残率。

The decompressive craniectomy （ DC ） should be performed as soon as possible when the brain edema and swelling can not be controlled after severe head injury. DC is helpful in decrease of the intracranial pressure, improvement of the brain blood circulation and metabolism, relief of brain hernia, rescue the life of patients and assistance in the usage of other therapies for the head trauma. The purpose of this paper is to review the mechanism, indication, procedure of the DC, and prevention and treatment of the complications. It helps to reduce the mortality and disable rate.