双额颞部一次成型去大骨瓣减压治疗外伤性弥漫性脑肿胀

Treatment of traumatic diffuse brain swelling with the once-forming large bilateral fronto-temporal decompressive craniotomy

目的探讨双额颞部开颅一次成型去大骨瓣减压术治疗外伤性弥漫性脑肿胀的疗效。方法回顾性分析16例弥漫性脑肿胀患者手术时整块去除双额颞部骨瓣、结扎矢状窦并完全剪开大脑镰减压治疗患者的临床效果。结果格拉斯哥预后量表(GOS)评分,恢复良好7例,中度残疾3例,重度残疾1例,植物生存2例,死亡3例。治疗后中重度患者的格拉斯哥昏迷量表(GCS)评分显著优于治疗前(P<0.05)。结论该术式是一种安全有效的治疗外伤性弥漫性脑肿胀的方法。

Objective To investigate the clinical therapeutic effect of the once-forming large bilateralfrontotempory decompressive craniotomy on traumatic diffuse brain swelling. Method The clinical data of 16 patients with diffuse brain swelling who had accepted the operation of the bilateral fronto-temporal decompressive craniectomy with the ligation of longitudinal sinus and the complete open of falx cerebri swelling,were analyzed retrospectively.Results According to the Glasgow outcome scale（ GOS） prognostic evaluation,of 16 patients,7 had good recovery,3moderated disability,1 severely disabled,2 in vegetable state,and 3 died. For the patients with moderate-to-severe brain injury,Glasgow coma scale（ GCS） score of the post-operation was significantly superior than that of the pre-operation（ P〈0. 05）. Conclusion The clinical curative effect of the surgery is a safe,certain method for the treatment of traumatic diffuse brain swelling.