摘要
目的比较大骨瓣减压与常规骨瓣减压治疗重度颅脑损伤的临床效果。方法总结我科2000-2004年间颅脑外伤病例符合重度颅脑损伤的97例,分两组,一组是大骨瓣(n=47)行单侧或双侧额颞顶骨瓣(12×14cm),另一组为常规骨瓣(n=50)颞顶瓣、额颞瓣、额瓣(6×8cm)开颅术。结果按伤后6个月随访预后结果(6-GOS)大骨瓣组:恢复良好20例,中残14例、重残6例、植物生存4例、死亡3例。常规骨瓣组:良好12例、中残10例、重残12例、植物生存8例、死亡8例(P<0．01)。大骨瓣减压组颅内压下降程度优于常规骨瓣组P<0．01。两组患者的术后并发症切口脑脊液漏、外伤性癫痫,颅内感染,外伤性脑积水(P>0．05),无显著性差异。结论大骨瓣减压治疗重度颅脑损伤的预后优于常规骨瓣组。
Objective To compare the clinical effect of treating severe head iniuries using the large craniectomy versus the routine craniectomy. Methods To summarize trauma cases in our department from 2000 to 2004. 97 cases were severe head injuries ,divided into two groups ：the large trauma craniectomy group（n=47） got unilateral or bilateral frontotemporoparietal bone flap（12 × 14cm）and routine temporoparietal craniectomy group （n = 50） received routine temporoparietal scalp flap（6×8cm）. Results Glasgow outcome scale was tested at 6 month fol- low-Up（6-GOS） ,in the large craniectomy group , 20 cases got good recovery, 14 cases got moderats deficit , 6 cases got severe deficit , 4 cases got persistent vegetative status and 3 cases were dead. In the routine craniectomy , 12 cases got good recovery , 10 cases got moderate deficit, 12 cases got severe deficit, 8 cases got persistent vegetative status and 8 cases were dead（P〈0.01）. Intracranial pressure decreased faster in large trauma craniectomy than in routine craniectomy （P〈0.01）. The complication of two groups ,including CSF fistulae,traumatic seizure ,intracranial infection and posttraumatic hydrocephalus （PTH）,was not significantly different （P〉0. 05）. Conclusion It proves that the large craniectomy significantly improve the outcome of severe traumatic brain injured patients with refractory intracranial hypertension.
出处
《中风与神经疾病杂志》
CAS
CSCD
北大核心
2005年第5期437-439,T0001,共4页
Journal of Apoplexy and Nervous Diseases
关键词
大骨瓣
常规骨瓣
重度颅脑损伤
预后
Large craniectomy
Routine craniectomy
Severe traumatic brain injury
Outcome
