去骨瓣减压术颅骨瓣面积大小的临床分析

目的探讨去骨瓣减压术前开颅骨瓣面积大小如何确定。方法总结分析158例重、特重型颅脑损伤去骨瓣减压的临床资料，选择GCS评分、瞳孔和头颅CT为依据，分析患者骨瓣得分，为开颅骨瓣计算方法。结果本组158例患者经过术后6个月以上随访，其中5级69例（43．67％），4级41例（25．95％），3级10例（6．33％），2级2例（1．27％），I级36例（22．78％）。结论采用颅骨瓣面积大小的计算方法安全、可行，可减少去选骨瓣盲目性，可有效提高治疗效率，改善患者预后。

Clinical analysis on area of skull flap in decompressive craniectomy

Objective To discuss how to determine the area of skull flap before decompressive craniectomy. Methods The clinical data of 158 cases with severe, very severe craniocerebral injury underwent decompressive craniectomy were summarized and analyzed.Selecting the GCS score,pupil and cranial CT as the basis,the bone flap score of patients were analyzed for the calculation method of bone flap in craniotomy. Results In 158 cases followed up for over 6 months after the surgery,there were the grade 5 in 69 cases（43.67%）, grade 4 in 41 cases（25.95%）,grade 3 in 10 cases（6.33%）,grade 2 in 2 cases（l.27%）,and grade 1 in 36 cases（22.78%）. Conclusion The calculation method of area of skull flap is safe and feasible, may reduce the choose blindness of bone flap,can effectively improve the efficiency of treatment,improve the prognosis of patients.