小硬脑膜窗口显露预防外伤性颅内血肿术中急性脑膨出的临床研究

Clinical Study of Effects of the Small Dural Window Exposure Strategy to Prevent Intraoperative Acute Encephalocele during Traumatic Intracranial Hematoma Evacuation

目的:探讨对合并脑疝形成的外伤性颅内血肿患者进行小硬脑膜窗口显露预防急性脑膨出的临床价值。方法:收集我院2005年1月至2007年1月收治符合标准的合并脑疝形成的外伤性颅内血肿患者126例,均行开颅去大骨瓣减压手术,治疗组67例行小硬脑膜窗口显露的方式进行血肿清除术,对照组59例采用传统的硬脑膜切开进行清除血肿清除术。结果:治疗组患者颅内压下降速度和程度优于对照组(P<0.05),治疗组术中急性脑膨出的发生率低于对照组(P<0.05)。结论:小硬脑膜窗口显露是预防急性脑膨出发生的一种有效手术方式。

Objective：To explore the value of small dural window exposure strategy to prevent intraoperative acute encephalocele during the surgery of patients with traumatic intracranial hematoma combined with herniation.Methods：126 cases of traumatic intracranial hematomas were divided into control and the treatment group,59 cases in the control group and 67 cases in the treatment group.In the treatment group,small dural window exposure and large bone flap decompression strategy was adopted.In the control group,traditional dural exposure strategy was adopted. Resuits： Intracranial pressure decreased faster and better in the treatment group than that of the control group （P〈 0.05）. The incidence of acute encephalocele in treatment group was lower than that of the control group （P〈0.05）. Conclusion： Small dural window exposure strategy to prevent intraoperative acute encephalocele during traumatic intracranial hematomas evacuation is effective for the patient with traumatic intracranial hematomas.