标准大骨瓣开颅术治疗急性硬膜下血肿35例临床分析

目的探讨标准大骨瓣开颅术治疗急性硬膜下血肿的手术方法及临床效果。方法回顾性分析3年来该院采用标准大骨瓣开颅术治疗的35例急性硬膜下血肿患者的病例资料。结果按格拉斯哥标准（GOS）对预后进行评估，全组35例中，治愈16例，中残7例，重残4例，死亡8例。术后并发症：迟发性血肿3例，外伤性脑梗塞1例，硬膜下积液3例，皮片坏死1例，减压区脑软化灶2例，颅内感染2例，外伤性癫痫3例。结论标准大骨瓣开颅术暴露良好、止血方便，能迅速清除血肿、缓解颅压，是治疗急性硬膜下血肿的有效手段。

Clinical analysis of standard large trauma craniotomy in treatment of acute subdural hematoma of 35 cases

[Objective] To investigate the surgical techniques and clinical outcome of standard large trauma craniotomy in the treatment of acute subdural hematoma. [Methods] The clinical data of 35 cases with acute subdural hematoma,who underwent standard large trauma craniotomy in recent 3 years in our hospital, were retrospectively analyzed. [Results] The outcome of all the patients was evaluated according to glasgow outcome scale(GOS) criteria.16 of 35 cases were cured. Midrange disability occurred in 7 cases, severe disability in 4 and mortality in 8.Postoperative complications included tardive haematoma in 3 cases, and traumatic cerebral infarction 1,subdural collection of fluid 3,skin graft thanatosis 1,cerebromalacia in depressor area 2,intracranial infection 2 and traumatic epilepsy 3. [Conclusion] Standard large trauma craniotomy is an effective approach in the treatment of acute subdural hematoma due to its advantages such as satisfactory exposure for haemostasis, rapid removal of haematoma and relief of acute intracranial hypertension.