去骨瓣减压术治疗脑外伤后急性大脑半球肿胀的疗效

Clinical efficacy of decompressive craniectomy in treatment of acute cerebral hemispheric swelling after cerebral trauma

目的探讨标准大骨瓣减压术对急性大脑半球肿胀的临床疗效。方法选择在我院进行治疗的急性颅脑外伤致大脑半球肿胀患者56例为研究对象,其中标准大骨瓣减压组30例,常规骨瓣组26例。比较两组手术后的颅内压情况、并发症情况、3个月后的GOS评分等。结果标准大骨瓣减压术的患者术后颅内压下降更明显,与常规骨瓣组比较,差异有统计学意义(P<0.05)。术后3个月,标准大骨瓣减压术的患者GOS评分4～5分的比例最高,显著高于常规骨瓣减压术的患者,而1分的患者比例显著低于常规骨瓣组,差异均有统计学意义(P<0.01)。结论标准大骨瓣减压术治疗急性大脑半球肿胀能够迅速降低颅压,改善预后,且不增加并发症的发生率。

Objective To discuss clinical efficacy of decompressive craniectomy in treatment of acute cerebral hemi- spheric swelling after cerebral trauma. Methods Selected 56 cases with acute cerebral hemispheric swelling after cere- bral trauma were retrospeciive analyzed. Standard large trauma craniotomy group has 30 cases, routine craniotomy group 26 cases. Intracranial pressure, complications, GOS 3 months after operation were compared. Results Standard large trauma craniotomy group decreased more than routine craniotomy group （P 〈 0.05）. Three months after operation, following-up GOS of two groups, cases with 4-5 score were most in standard large trauma craniotomy group, 1 score was lowest, which had significant difference with routine craniotomy group （P 〈 0.01）. Conclusion Decompressive cranieetomy in treatment of acute cerebral hemispheric swelling after cerebral trauma can decreased intracranial pres- sure, improving prognosis, without increasing complications.