扩大硬膜成形在大骨瓣减压术中的临床应用效果

Clinical application of expanding dural plasty in greater bone flap decompression

目的:探讨硬膜扩大成形大骨辨减压术同常规颞肌下减压术在重型颅脑损伤、脑疝形成所致恶性颅内高压症中的治疗效果。方法:回顾性分析重型颅脑损伤采用扩大硬膜成形术30例和采用常规颞肌下减压30例患者的治疗效果及并发症发生率。结果:扩大硬膜成形术组良好率、中残率显著提高(P<0.01),脑膨出、脑穿通畸形、脑脊液漏颅内感染发生明显减少(P<0.05)。结论:扩大硬膜成形大骨瓣减庄术优于常规颞肌下减压术,值得临床推广应用。

To discuss the effects of expanding dural plasty in greater bone flap decompression and conventional decompression for treating severe craniocerebral injury and malignant intracranial hypertension induced by cerebral herniation.Methods： To retrospectively analyze the curative effects and the complication rates in 30 cases of expanding dural plasty and 30 cases of conventional subtemporal decompression.Results：The good effect rate and the moderate disable rate in the expanding dural plasty group were obviously enhanced （P〈O.O1）.The occurrence of encephalocele,poreneephalia, cerebrospinal leak and intracranial infection was significantly reduced （P〈O.O5）.Conclusion：Expanding dural plasty in greater bone flap decompression is superior to the conventional subtemporal decompression,which is worth being promoted in clinic.