颅脑损伤术后脑突出的外科处理

Surgical Treatment of Encephalo-protrusion Caused by External Decompression in Patients with Traumatic Brain Injury

目的探讨颅脑损伤术后脑突出的治疗方法。方法因颅脑损伤行开颅去骨瓣减压术后出现颅内感染并脑突出患者22例,按入院先后顺序分为两组,联合治疗组11例,在常规药物治疗的同时,行外科清创后腰穿置管引流脑脊液;对照组11例,常规药物治疗的同时仅行外科清创。对比两组疗效。结果治疗组患者在控制感染时间、临床症状改善时间和平均住院时间等方面较对照组效果显著(P<0.05)。结论外科清创联合腰穿置管引流脑脊液治疗颅脑损伤后脑突出安全、迅速、有效。

Objective To explore the optimal method to treat encephalo-protrusion and intracranial infection caused by external decompression in the patients with traumatic brain injury （TBI）. Methods Twenty-two patients with encephalo-protrusion and intracranial infection after external decompression due to TBI were randomly divided into two groups, i.e. control group （11 cases）, in whom routine treatment and debridement were performed, and treatment group （11 cases）, in whom routine treatment, debridement and continual drainage of cerebrospinal fluid by lumber puncture were performed. The continual drainage of cerebrospinal fluid was performed after debridement. The curative effects were compared between both the groups. Results The time of controlling infection, time of improving clinical symptoms, and average stay were significantly shorter in the treatment group than those in the control group （P〈0.05）. Conclusion Continual drainage of cerebrospinal fluid after debridement is a safe, rapid and effective method to treat encephalo-protrusion and intracranial infection in the patients with TBI.