重型颅脑对冲伤术中急性脑膨出手术方式的探讨

Analysis of surgery methods of acute encephalocele in severe counter coup brain injury

目的:探讨两种手术方法治疗重型颅脑对冲伤术中急性脑膨出的临床疗效。方法:48例重型颅脑对冲伤术中急性脑膨出患者分别行标准外伤大骨瓣开颅减压术(A组,n=26例)及常规骨瓣开颅减压术(B组,n=22例),比较两种方法的疗效。结果:A组预后良好率为76.9%高于B组的40.9%(P<0.05);A组死亡率为11.5%显著低于B组的40.9%(P<0.05)。结论:标准外伤大骨瓣开颅减压术较常规骨瓣开颅减压术对治疗重型颅脑对冲伤术中急性脑膨出疗效更佳,并能有效改善预后,降低死亡率。

Objective：To compare two surgery way and curative effect of acute encephalocele in severe countrecoup brain injury.Methods：48 patients with acute encephalocele were treated by standard large trauma craniotomy（A group,n=26） or routine temporoparietal craniotomy（B group,n=22）.The two groups were compared prospectively curative effect.Results：In A group 19 cases got good recovery（76.9%） than B（40.9%）;A group got lower dead rate（11.5%） than B（40.9%）.Conclusion：Standard large trauma craniotomy can prevent and treat acute encephalocele in severe counter coup brain injury successfully and improve the prognosis and reduce them ortality.