急性硬膜外血肿合并脑疝术后复位骨瓣40例

Postoperative bone flap restoration in 40 acute epidural hematoma complicated with cerebral hernia cases

目的研究急性硬膜外血肿合并脑疝术后复位骨瓣的临床体会。方法 80例急性硬膜外血肿合并脑疝患者,随机分为A组和B组,各40例。A组给予开颅血肿清除+骨瓣复位术治疗,B组给予开颅血肿清除+去骨瓣减压术治疗。对比分析两组治疗效果。结果 A组患者中有3例行二次去骨瓣减压术;A组患者的术后昏迷时间明显短于B组(P<0.05),致残率明显低于B组(P<0.05)。结论对急性硬膜外血肿合并脑疝患者行开颅血肿清除+骨瓣复位术治疗能在达到手术治疗目的的基础上避免二次手术,减轻患者的病痛,且致残率低,有助于改善预后。

Objective To research clinical experience of postoperative bone flap restoration for acute epidural hematoma complicated with Cerebral hernia. Methods A total of 80 acute epidural hematoma complicated with cerebral hernia patients were randomly divided into group A and group B, with 40 cases in each group. Group A received craniotomy hematoma clearance ＋ bone flap restoration, and group B received craniotomy hematoma clearance ＋ decompressive craniectomy. Curative effects were compared between the two groups. Results There were 3 cases receiving secondary decompressive craniectomy in group A. Postoperative coma time was obviously shorter （P〈0.05） and disability rate was much lower in group A than group B （P〈0.05）. Conduslon Implement of craniotomy hematoma clearance ＋ bone flap restoration for acute epidural hematoma complicated with cerebral hernia patients can avoid secondary operation on the basis of accomplishing surgical goal. This method can relieve pain, reduce disability rate, and it is helpful for prognosis improvement.