标准外伤大骨瓣开颅术治疗额颞顶部广泛对冲伤的临床研究

目的 探讨标准外伤大骨瓣开颅术治疗额颞顶部广泛对冲伤的临床应用价值。方法 采用标准外伤大骨瓣开颅术对46例额颞顶部广泛对冲伤患者进行手术治疗，术后3～6个月采用格拉斯哥预后分级标准进行临床疗效的评定，并对并发症进行分析。结果 预后良好22例（47．83％），中度残疾6例（13．04％），莛度残废4例（8．7％），死亡14例（30．43％）。术后主要并发症为迟发性颅内血肿、脑穿通畸形、脑积水、颅骨缺损综合征等。结论 标准外伤大骨瓣开颅术是治疗额颞顶部广泛对冲伤（尤其是单侧）的良好手术方式。

Clinical study of standard large trauma craniotomy on frontotemporal and parietal contrecoup craniocerebral injury

Objective To evaluate the value of standard large trauma craniotomy in frontotemporal and parietal contrecoup craniocerebral injury.Methods Forty-six patients with frontotemporal and parietal contrecoup craniocerebral injury were treated by standard large trauma craniotomy. Based on GOS, the clinical curative effect and complications of these patients during 3 to 6 months after operation were evaluated.Results 22 cases (47.83%) recovered well, 6 cases (13.04%) suffered from moderate disability, 4 cases (8.7%) remained severe disability, and 14 cases (30.43%) died. The common complications after operation were delayed intracranial hematoma, cerebral penetrating malformation, hydrocephalus, defect of skull syndrome and so on.Conclusion Standard large trauma craniotomy is a good therapeutic method for frontotemporal and parietal contrecoup craniocerebral injury.