半球骨瓣减压结合控制性减压治疗特重型颅脑损伤

目的：探讨半球骨瓣减压结合控制性减压治疗特重型颅脑损伤的临床疗效。方法采用去半球大骨瓣彻底减压技术,结合硬脑膜网状切开和有限渐次减压法等控制性减压,对60例特重型颅脑损伤患者进行手术治疗,术后6个月进行GOS评分评价,3～4分为良好,2分为中度残废,1分为重度残废。结果死亡25例（病死率为41．7％）,存活35例,其中恢复良好10例,中度残废1例,重度残废14例。结论去半球骨瓣伴控制性减压技术具有显露好、减压充分等优点,可有效降低手术病死率。

Hemi-spheric craniotomy combined with controlled decompression in treatment of extra severe-craniocerebral injuries

Objective To investigate the clinical efficacy of hemi-spheric craniotomy combined with controlled decompression in treating extra severe-craniocerebral injuries.Methods Sixty patients with extra-severe craniocerebral injuries were operated by hemi-spheric craniotomy,and the controlled decompression of dural netted incision and limited decompression was gradually performed in the patients.The patients were followed up for 6 months,in which 3 to 4 scores were good prognosis and 2 scores were moderate disability and 1 score was se-vere disability according to GOS scores.Results Twenty-five cases died（the mortality rate was 41.7%）,35 cases survived,among whom 10 cases had good prognosis,1case moderate disability and 14 cases severe disability.Conclusion The hemi-spheric craniotomy combined with controlled decompression can decrease the mortality rate by good exposure and adequate decompression.