硬脑膜补片在重型颅脑损伤去骨瓣减压术中的临床应用研究

Clinical effect of Dura Max used in decompressive craniotomy of severe traumatic head injury

目的探讨硬脑膜补片在重型颅脑损伤去骨瓣减压术中的临床应用。方法78例额颞叶脑挫裂伤患者,随机分为A组40例行去骨瓣减压术同步行硬脑膜补片修补硬膜和B组38例行去骨瓣减压硬膜敞开。比较术后并发症的情况、术后半年随访患者GOS情况。结果A组并发脑膨出(0)、脑室穿通畸形(2.5%)、硬膜下或皮下积液(17.5%)、脑脊液漏(5%)、颅内感染(7.5%)明显低于B组;半年后评价A组GOS评分明显高于B组。结论重型颅脑损伤去骨瓣减压术中应用硬脑膜补片修补硬膜,可以减少术后并发症,改善患者愈后,该方法操作简单,值得临床推广。

Objective To investigate the clinical effect of Dura Max used in decompressive craniotomy of severe traumatic head injury. Methods 78 cases with frontal-temporal contusion and laceration were randomly divided into A group（40 cases）and B group（38 cases）. The patients of A group used Dura Max during decompressive craniotomy, but the patients of B group opened widely dura during decompressive craniotomy. Postoperative complications and GOS were compared during A group and B group. Results The patients of A group had the lower incidence rate of postoperative complications than B group. The GOS score was significant difference between the two group （ P 〈 0.05 ）. Conclusion Dura Max is used in decompressive craniotomy of severe traumatic head injury that can decrease the rate of postoperative complications and improve the patients recover. This method is easy to be performed, so it is deserved to be applied widely.