标准去大骨瓣开颅术在脑外伤后合并颞肌血肿中的意义

Significance of Standard Large Trauma Craniotomy in the Combined Temporal Muscle Hematoma after Traumatic Brain Injury

目的探讨标准去大骨瓣开颅术在脑外伤后合并颞肌血肿中的临床疗效。方法回顾性研究134例开颅去骨瓣患者的临床资料,其中应用标准去大骨瓣开颅术76例,常规骨瓣开颅减压58例,对比分析开颅术后颞肌血肿出现的几率,因颞肌血肿需接受二次手术的几率。结果 标准去大骨瓣开颅术组76例中出现颞肌血肿13例,接受二次手术2例,因颞肌占位手术1例。常规治疗组58例,出现颞肌血肿10例,接受二次手术7例,其中因颞肌占位手术5例。结论标准去大骨瓣开颅术增加了颞肌损伤的机会,但骨窗减压充分,出现颞肌血肿后脑组织移位不明显,接受二次手术较常规手术组明显减少。

Objective To discuss significance of standard large trauma craniotomy after traumatic brain injury in the combined temporal muscle hematoma. Methods A retrospective study 134 cases of bone flap craniotomy to clinical data,including application of standards large trauma craniotomy in 76 cases,conventional craniotomy decompression in 58 cases,comparative analysis of temporal muscle hematoma after craniotomy appeared likely because of temporal muscle hematoma secondary operation likely to be accepted. Results Large trauma craniotomy group to 76 cases of temporal muscle hematoma appeared in 13 cases,2 cases received reoperation due to space-occupying temporal muscle surgery is 1 case. Conventional treatment group,58 patients with temporal muscle hematoma occurred in 10 cases,7 cases received second operation,in which space-occupying temporal muscle surgery for 5 patients. Conclusion The de-compressive eraniotomy on temporal muscle damage to a statistically significant difference,but the bone window adequate decompression,temporal muscle hematoma appeared obvious shift in brain tissue,to accept the second surgery was significantly higher than with conventional surgery statistically significant.