锥颅碎吸术联合开颅血肿清除术及去骨瓣减压术在重型颅脑损伤并双侧脑疝患者中的应用价值

目的探讨急诊锥颅碎吸术联合开颅血肿清除术在重型颅脑损伤并双侧脑疝患者中的应用价值。方法回顾分析本院150例重型颅脑损伤并双侧脑疝患者的救治资料。结果150例患者中临床痊愈32例,中残60例,重残12例,植物生存6例,死亡40例,抢救成功率73%,死亡率27%。结论急诊锥颅碎吸术,开颅血肿清除术及去骨瓣减压术,配合药物治疗尽快使移位脑组织复位等综合措施能最大限度的降低重型颅脑损伤的死亡率,明显提高患者的生活质量。

Efficacy of drainage through cranial trephination combined with craniotomy and hematoma removal and decompression by removal of cranial bone flaps in treatment of severe cranio-cerebral injury combined with bilateral cerebral hernias: report of 150 cases

Objective To explore the value of drainage through cranial trephination combined with craniotomy and hematoma removal and decompression by removal of cranial bone flaps in treatment of patients with severe craniocerebral injury combined with bilateral cerebral hernias. Methods The clinical data of 150 patients, 110 males and 40 females, aged 37.4 (8~69), with severe cranial cerebral injury combined with bilateral cerebral hernias, all caused by trauma, 116 traffic accident, 24 by fall, and 10 by hitting/beating, who underwent drainage through cranial trephination combined with craniotomy and hematoma removal and decompression by removal of cranio-bone flaps within the period 0.5~16 h after the trauma, were analyzed. Results Clinical recovery was achieved in 32 out of the 150 patients. Sixty patients survived with medium disability, 12 survived with serious disability, 6 cases were in vegetable state, and 40 died. The rescue success rate was 73% and the mortality was 27%. Conclusion Drainage through cranial trephination combined with craniotomy and hematoma removal and decompression by removal of cranial bone flaps helps replace the displaced brain tissues, lower the mortality of severe craniocerebral injury, and raise the life quality of the patients.