标准大骨瓣减压治疗颅脑损伤临床效果分析

目的：分析标准大骨瓣减压治疗重型颅脑损伤的临床效果。方法：对78例重型颅脑损伤（格拉斯哥昏迷评分≤8分）患者采用标准大骨瓣开颅术减压,术后6个月,根据格拉斯哥预后评定标准对其进行评定,并观察其并发症。结果：术后出现迟发血肿9例,切口脑脊液漏2例,对侧硬膜下积液5例,肺部感染3例,癫痫1例。术后6个月78例均获得随访,恢复良好16例,中残17例,重残15例,植物生存12例,病死18例;术后因继发颅内高压而再次手术患者5例。结论：标准大骨瓣减压术是治疗重型颅脑损伤较为理想的手术方式,但术后应密切观察患者的生命特征,出现并发症时要做到早发现早处理。

Clinical effect of standard mega-bone flap craniotomy decompression in the treatment of craniocerebral injury

Objective：To analyze the clinical effects of standard mega-bone flap craniotomy decompression in the treatment of severely craniocerebral injury. Methods：Seventy-eight patients with severely craniocerebral injury（Glasgow Coma Scale≤8 points） were treated with standard mega-bone flap craniotomy decompression. The Glasgow Outcome Scale and complications of all patients were observed in6 months after treatment. Results：The delayed intracranial hematoma in 9 cases,cerebrospinal fluid leakage of incision in 2 cases,bilaterally subdural effusion in 5 cases,lung infection in 3 cases and epilepsy in 1 case were found after operation. All cases were followed up,good recovery in 16 cases,moderate disabilities in 17 cases,severe disabilities in 15 cases,vegetative state in 12 cases and death in 18 cases were verified. Five cases with secondary intracranial pressure were operated again. Conclusions：The standard megabone flap craniotomy decompression is an ideal surgical method in treating severely craniocerebral injury. The vital signs of patients after surgery should be closely observed,early detection and treatment of complications are important.