重型颅脑损伤外减压治疗效果观察

The efficacy of external decompression for severe traumatic brain injury

目的探讨大骨瓣开颅外减压手术治疗重型颅脑损伤的效果。方法回顾我院2009年1月至2012年8月我院收治的72例重型颅脑损伤患者的临床资料，笔者采用大骨瓣外减压手术方式对72例患者进行减压处理。结果72例患者存活64例，8例因救治不及时术中或术后死亡。存活患者经过1-2年的随访，按GOS评分分级，良好38例，中度残废14例，重度残废9例，3例呈植物人状态。8例死亡的患者中，脑干严重损伤而死亡4例，2例死于严重并发症，2例放弃治疗。结论大骨瓣开颅减压手术治疗重型颅脑损伤效果明显，手术方法及时有效。

Objedive To explore the efficacy of large decompressive craniectomy for patients with se- vere traumatic brain injury. Methods The clinical data on 72 patients with severe traumatic brain injury who hadbeen admitted to our hospital during the period of January 2009 to August 2012 were retrospectively reviewed. All the patients were treated by large decompressive craniectomy. Resulls 64 of the 72 patients survived; while $ died intraoperatively and postoperatively because of delayed treatment. The survivors were graded according to the Glasgow Outcome Scale （GOS） in a follow-up of 1 to 2 years. 38 survivors has better recovery, 14 were moderately disable, 9 were severely disable, and 3 were in vegetative state. Of 8 patients who were dead, 4 died of severe brainstem injury, 2 died of severe complications, and the rest 2 died from abandonment of treatment. Conclusions Large decompressive craniectomy is efficacious in the treatment of severe traumatic brain injury.