去骨瓣减压+颞肌切除术在重型颅脑损伤中的应用

DECOMPRESSIVE CRANIECTOMY+TEMPORALIS MUSCLE RESECTION IN SEVERE TRAUMATIC BRAIN IN JURY APPLICATION

目的:分析重型颅脑损伤去骨瓣减压+颞肌切除术的有效性、合理性及结果。方法:对46例重型颅脑损伤病人行标准大骨瓣去骨瓣减压+颞肌切除,采用回顾性分析,总结该类病人的特点及有效性。结果:按照格拉斯哥预后评分(Glasgowoutcomescale,GOS),46例病人其中良好8例(17.3%),中度残废6例(13%),重度残废9例(19.5%),植物生存10例(21.7%),死亡13例,死亡率为28.2%。结论:去骨瓣减压+颞肌切除术在重型颅脑损伤的抢救、缓解颅内压升高以及解除脑组织受压是有效的手段,采用颞肌切除代替切除更多正常脑组织,扩大硬膜腔,使颅内代偿空间进一步扩大的治疗能提高抢救成功率,降低病死率、致残率,提高生活质量。

Objective： Purpose Analysis of severe head injury decompressive craniectomy ＋ temporalis muscle resection is effective, rational and results. Methods： Of 46 cases of severe head injury patients to expand the pterianal craniotomy decompression temporalis muscle resection, a retrospective analysis, summarized the characteristics and effectiveness of these patients. Results：In accordance with the Glasgow Outcome Scale （Glasgow outcome scale, GOS） ,46 patients in which good in 8 cases （ 17.3% ） ,moderate disability in 6 cases （ 13% ） , severe disability in 9 cases （ 19.5% ） ,plant survival in 10 cases （21.7%）, 13 patients died ,mortality was 28.2%. Conclusion：Decompressive craniectomy ＋ temporalis muscle resection of the rescue in severe brain injury, relieve intraeranial pressure and relieve pressure on brain tissue is an effective means of temporal muscle resection with removal of more normal brain tissue instead of expand the dural cavity, the space for further expansion of intracranial compensatory therapy can improve the success rate and reduce the mortality, morbidity, quality of life.