标准外伤大骨瓣开颅术治疗重型颅脑损伤合并脑疝30例分析

Analysis of treatment of severe traumatic brain injury combined with herniation with standard large trauma craniotomy

目的探讨标准外伤大骨瓣开颅减压术对重型颅脑损伤合并脑疝的疗效。方法采用标准外伤大骨瓣开颅减压术治疗30例重型颅脑损伤合并脑疝患者,并与同期采用常规开颅减压术28例的疗效进行比较。结果随访6个月,根据GOS评分法评定疗效,治疗组30例,恢复良好17例(56.7%),恢复不良5例(16.7%),死亡8例(26.6%);对照组28例,恢复良好12例(42.8%),恢复不良5例(17.9%),死亡11例(39.3%),组间比较,差异有统计学意义(P<0.05)。结论标准外伤大骨瓣开颅术是救治重型颅脑损伤合并脑疝患者的有效方法,其操作简便,减压彻底,能有效降低患者的残死率,值得临床推广应用。

Objective To explore the efficacy of standard large trauma craniotomy decompression on severe trau- matic brain injury with herniation. Methods 30 patients with severe traumatic brain injury with herniation were treated with standard large trauma craniotomy decompression and controlled with 28 cases with routine craniotomy at the same period. The efficacy was analyzed. Results According to GOS score, 17 cases recovered （56.7;） and 8 casses died （26.6%） in treatment group. 12 cases recovered （42. 8%） and 11 casses died （39.3%） in control group. Conclusion It is an effective method to treat severe traumatic brain injury with brain herniation with standard large trauma craniotomy.