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Complications induced by decompressive craniectomies after traumatic brain injury 被引量:46

Complications induced by decompressive craniectomies after traumatic brain injury
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摘要 Objective: To find out the optimal approach to decompress externally the severe injured brain and to avoid possible complications caused by external decompression. Methods: 68 patients who underwent external decompression after traumatic brain injury were admitted into Tianjin Medical University General Hospital for cranioplasty from 1995 to 2001. Complications were retrospectively investigated and analyzed in all patients. The findings were compared between the patients who accepted the decompressive craniectomy in our hospital and in local hospitals. χ 2-test was employed for statistical analysis and complication evaluation. Results: Large craniectomy definitely caused some side effects to patients. Among various complications, several of them showed significantly high incidence (P< 0.05) in patients who underwent the decompressive operation in local hospitals such as shunt-dependent hydrocephalous, subdural fluid collection, and CSF leakage from scalp incision. The rest of the complications had no remarkable difference (P> 0.05) between the two groups including dilation or/and migration of lateral ventricle underlying the cranial defect, skin flap concavity, encephalomalacia of the decompressive area, seizure and infection. Conclusions: To reduce the incidence of iatrogenic side effects, surgical craniectomy should be performed according to the strict indication and standard and any abuse should be avoided. Objective: To find out the optimal approach to decompress externally the severe injured brain and to avoid possible complications caused by external decompression. Methods: 68 patients who underwent external decompression after traumatic brain injury were admitted into Tianjin Medical University General Hospital for cranioplasty from 1995 to 2001. Complications were retrospectively investigated and analyzed in all patients. The findings were compared between the patients who accepted the decompressive craniectomy in our hospital and in local hospitals. χ 2-test was employed for statistical analysis and complication evaluation. Results: Large craniectomy definitely caused some side effects to patients. Among various complications, several of them showed significantly high incidence (P< 0.05) in patients who underwent the decompressive operation in local hospitals such as shunt-dependent hydrocephalous, subdural fluid collection, and CSF leakage from scalp incision. The rest of the complications had no remarkable difference (P> 0.05) between the two groups including dilation or/and migration of lateral ventricle underlying the cranial defect, skin flap concavity, encephalomalacia of the decompressive area, seizure and infection. Conclusions: To reduce the incidence of iatrogenic side effects, surgical craniectomy should be performed according to the strict indication and standard and any abuse should be avoided.
出处 《Chinese Journal of Traumatology》 CAS 2003年第2期99-103,共5页 中华创伤杂志(英文版)
关键词 减压部分颅骨切除术 创伤性脑损伤 并发症 手术指征 临床研究 Brain injuries Decompression Postoperative complications
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参考文献5

  • 1Munch E,Horn P,Schurer L,et al.Management of severe traumatic brain injury by decompressive craniectomy[].Neurosurgery.2000
  • 2Guerra WK,Gaab MR,Dietz H,et al.Surgical decompression for traumatic brain swelling: indications and results[].Journal of Neurosurgery.1999
  • 3Coplin WM.Intracranial pressure and surgical decompression for traumatic brain injury: biological rationale and protocol for a randomized clinical trial[].Neurological Research.2001
  • 4Bullock R,Chesnut RM,Clifton G,et al.Critical pathway for the treatment of established intracranial hypertension[].Journal of Neurotrauma.2000
  • 5Lai RL,Zheng FR,Xu JC.Standard large bone craniectomy applied in the treatment of acute subdural hematoma in 42 cases[].Chinese Journal of Traumatology.2000

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