改良外伤大骨瓣治疗重型脑外伤

Decompression with modified large craniectomy for the treatment of severe traumatic brain injury

目的 探讨改良外伤大骨瓣开颅术治疗重型脑外伤的临床效果.方法 对标准外伤大骨瓣的切口、骨瓣进行改良,用于65例重型脑外伤患者的手术治疗.结果 按GOS评分,术后3个月进行随访：良好40例,中残5例,重残9例,植物生存3例,死亡8例,无一例发生脑脊液漏、脑嵌顿、颅内感染.结论 改良外伤大骨瓣是治疗重型脑外伤安全有效的手术方式.

Objective To explore the value of modified large craniectomy in the treatment of severe traumatic brain injury. Methods A group of 65 patients with severe traumatic brain injury were treated with modified large craniectomy. The incision of scalp and the flap of cranial bone were modified. Results According to Glasgow outcome scale standard, a follow - up was conducted after 3 months, which indicated that 40 cases got good recovery, 5 cases got moderate defect, 9 cases got severe defiect, 3 cases were living in vegetative state and 8 cases were dead. None got incision cerebrospinal fluid fistula,encephalomyelocele and intracranial infection. Conclusion The modified large craniectomy is the effective and safe craniectomy for the severe traumatic brain injury .