术前锥(钻)颅减压救治创伤性脑疝32例患者的临床研究

目的探讨创伤性脑疝患者术前行锥(钻)颅引流减压对预后的影响。方法回顾性分析南通市第三人民医院神经外科2006年1月至2013年10月55例颅脑损伤后因幕上硬膜外(下)血肿致急性脑疝患者的临床资料,其中32例患者开颅手术前床旁紧急锥(钻)颅引流减压进行抢救,23例患者直接行开颅手术治疗,两组进行对照比较。结果锥(钻)颅组32例中有22例(69%)经紧急锥(钻)颅减压后瞳孔明显回缩,其中15例意识有好转。GOS预后评分在两组分布差异有统计学意义,锥(钻)颅组预后明显好于对照组。结论锥(钻)颅引流减压简单、易行,是颅脑损伤后因幕上硬膜外(下)血肿压迫致急性脑疝形成的一种重要抢救手段,配合开颅手术,疗效显著,值得推广。

Emergent Burr Hole Drainage Followed by Decompressive Craniotomy Improves the Clinical Outcome of Traumatic Brain Hernia

Objective To investigate the clinical benefits of emergent burr hole drainage followed by decompressive craniotomy for patients with traumatic brain hernia. Methods A total of 55 patients（admitted to our hospital from January 2006 to October 2013）with brain hernia caused by acute traumatic epidural or subdural hematoma were chosen in our study;32 of them were treated with emergent burr hole drainage followed by dccompressive craniotomy（emergent bur hole drainage group）and 23 of them were treated with decompressive craniotomy alone（ordinary decompression group）.Glasgow Outcome Scale（GOS）scores were evaluated retrospectively analyzed between them. Results Patients in ordinary decompression group had higher GOS scores than those in emergent burr hole drainage group（P〈0.05）. Pupil reWaction were found among 22 patients in emergent burr hole drainage group .Conclusion Emergent burr hole drdinage followed by deeompressive craniotomy is an effective method in saving patients with brain bemia caused by acute traumatic intracerebral haematoma, which can notably resolve intraeranial hypertension as soon as possible and give longer time for surgery, therefore, it can improve the prognosis.