重型颅脑损伤外减压效果的术中对策

Intraoperative Strategies of Severe Head Injury Decompression Effect

目的:探讨重型颅脑外伤急诊救治中,提高标准大骨瓣手术外减压手术疗效的步骤、操作方法。方法:50例重型颅脑损伤行标准大骨瓣减压手术,术中根据脑伤性质、程度、范围,采取天幕切开、蝶骨嵴咬除、扩大或游离头皮瓣、硬膜袋状缝合等方法,辅以内减压,尽可能扩大外减压手术效果。结果:良好25例(50%)、中残10例(20%)、重残5例(10%),死亡及其他10例(20%)。结论:围绕术中充分有效减压的目的,变通优化标准大骨瓣开颅手术操作,可以减少术后并发症,提高重型颅脑损伤的外科手术救治成功率。

Objective：To explore the emergency treatment of severe brain injury, improve the steps,operation methods of standard large trauma surgery outside surgical decompression.Methods：Severe brain injury people of 50 cases operated standard large trauma decompression surgery, in accordance with the nature,extent,scope for brain injury patients,take open atrium,bite sphenoid ridge,expand or free flap head,subdural pocket stitching and other methods,supplemented by decompression,maximize the effect of external decompression surgery.Results：Good in 25 cases （50%）,moderate disability in 10 patients （20%）,severe disability in 5 cases （10%）,death and other in 10 cases （20%）.Conclusion：Around the purpose of full and effective decompression surgery, flexible optimization of standard large trauma craniotomy operation.can reduce complications and improve the severe head injury treatment success rate of surgery.