摘要
目的探讨标准大骨瓣减压加坏死脑组织清除治疗外伤后恶性脑肿胀的疗效。方法80例伴发外伤后恶性脑肿胀的重型颅脑损伤患者，40例行标准大骨瓣开颅减压手术治疗，40例行标准大骨瓣开颅减压加坏死脑组织清除手术治疗，术后15d及术后6个月观察治疗效果，对结果进行比较分析。结果标准大骨瓣减压加坏死脑组织清除手术治疗组患者术后15d内颅高压发生率37．5％（15／40）、脑组织切口疝发生率32．5％（13／40），均明显低于单纯标准大骨瓣减压手术治疗组，分别为15．O％（6／40）和10．0％（4／40），P〈0．05，伤后6个月患者优良（良好＋中残）率（60．0％）显著高于单纯标准大骨瓣减压手术治疗组（40．0％），P〈0．05。结论采用标准大骨瓣减压加坏死脑组织清除手术可有效降低外伤后恶性脑肿胀患者的颅高压，降低重型颅脑损伤患者病死率和致残率，提高治疗效果。
Objective To observe the curative effects of malignant brain swelling after brain injury by using the operations of standard large Craniotomy decompression and removal of necrotic brain tissues. Methods 80 cases of malignant brain swelling after severe brain injury were observed. The standard decompression surgery of large craniotomy routine were used in 40 cases, while the operations of standard large craniotomy decompression and removal of necrotic brain tissues were used in the other 40 cases. The curative effects of the results after 15 days and six months were analyzed. Results The incidence of intracranial hypertension （37. 5%, 15/40 ） and brain tissue ineisional hernia （32.5%, 13/40）of the group using standard large craniotomy decompression and removal of necrotic brain tissues treatment was significantly lower than that of simple standard large craniotomy decompression treatment group [ 15.0% （6/40） vs 10.0% （4/40） ] after 15 days （ P 〈 0.05 ）. The prognosis excellent rate （ good ＋ residual） of the group using standard large Craniotomy decompression and removal of necrotic brain tissues ireatment was significantly higher （60.0%） than that of simple standard large craniotomy decompression treatment group （40.0%） after six months （P 〈 0.05）. Conclusion The operations of standard large craniotomy decompression and removal of necrotic brain tissues can effectively reduce the intracranial hypertension of malignant brain swelling after trauma injury, and reduce mortality and morbidity of severe brain injury.
出处
《中国综合临床》
2009年第5期539-542,共4页
Clinical Medicine of China
关键词
颅脑损伤
脑肿胀
标准大骨瓣减压
坏死脑组织清除
Brain injury
Brain swelling
Standard large craniotomy decompression
Removal of necrotic brain tissues
