标准外伤大骨瓣减压术治疗重型颅脑损伤的临床效果

Standard Trauma Big Bone Flap Pressure-reduction Operation Treat Severe Brain Injury

[目的]探讨标准外伤大骨瓣减压术治疗重型颅脑损伤的临床效果。[方法]对90例重型颅脑损伤患者均采用标准外伤大骨瓣开颅减压术治疗并观察其治疗效果。[结果]伤后1年随访,生存75例,其中50例(55.5%)预后良好,中残15例(16.6%),重残5例(5.5%),植物生存2例(2.2%),死亡18例(20.0%)。其中死亡病例基本为瞳孔散大或呼吸不规则或CT示:环池、鞍上池消失者,病因基本为多器官功能衰竭、肺部感染等。[结论]标准外伤大骨瓣减压术可使脑组织得到充分减压,有效保护脑功能,明显改善重型颅脑损伤患者的预后,降低病死率。

[Objective]To explore the clinical effect of standard trauma big bone flap pressure-reduction operation on severe brain injury. [Method]90 cases take the said therapy,then observe the cure effect. [Result]Make follow-up after one year,75 cases survived,among which, 50（55.5%） had good prognosis, 15 （16.6%） middle handicapped, 5 （5.5%） severely handicapped, 2 （2.2%） lived as plant, 18 （20.0%） dead. Among the dead ones, they basically had platycoria or abnormal breath, or their CT showed missing sicterna ambiens and upper sella ambiens, mostly caused by multi-organ failure and lung infection, etc. [Conclusion]The said therapy can fully reduce the pressure, effectively protect brain function,markedly improve the prognosis of the said disease,and decrease death rate.