标准大骨瓣开颅术治疗重型颅脑损伤的临床观察

The clinical application of standard craniotomy with large bone flap for frontal-temporal severe craniocerebral injury patients

目的探讨采用标准大骨瓣开颅术治疗额颞部重型颅脑损伤的疗效。方法对63例额颞部重型颅脑损伤患者采用标准大骨瓣开颅术。全部患者均进行随访，按GOS评分法判断预后。结果术后随访1年，恢复良好28例，中残12例，重残4例，植物生存状态3例，死亡16例，病死率为25．4％。结论标准大骨瓣开颅术是治疗额颞部重型颅脑损伤的较好方法。及早、彻底地施行标准大骨瓣开颅术能明显提高额颞部重型颅脑损伤患者的疗效，降低病死率。

Objective To explore the curative effect of standard craniotomy with large bone flap of the treatment for frontal-temporal severe craniocerebral injury patients. Methods Standard craniotomy with large bone flap was performed on 63 patients with frontal-temporal severe craniocerebral injury. All postoperative patients were followed up. The curative effect was assessed according to GOS. Results All patients were followed up for 1 year. According to the GOS,28 cases recovered well, 12 cases became moderately disabled,4 cases were severely disabled, 3 cases was in vegetative state and 16 cases died. The mortality rate was 25.4 %. Conclusions Standard craniotomy with large bone flap is the best method of the treatment for frontal-temporal severe craniocerebral injury. Timely and thoroughly standard craniotomy with large bone flap for frontal-temporal severe craniocerebral injury patients can significantly improve the the curative effect of the patients and reduce the rate of mortality.