标准外伤大骨瓣减压术与常规骨瓣减压术治疗严重对冲性颅脑损伤的临床对比研究

目的评价标准外伤大骨瓣减压手术治疗严重对冲性颅脑损伤的疗效。方法32例脑疝形成的对冲性颅脑损伤患者采用标准外伤大骨瓣开颅内外减压手术治疗,并与同期收治的24例常规骨瓣开颅手术组进行比较,分析其疗效。结果标准外伤大骨瓣减压手术治疗组32例中,恢复良好21例(占65.6%),死亡5例(占15.6%);常规骨瓣开颅手术组24例中,恢复良好9例(占37.5%),死亡10例(占41.7%)。2组对比,恢复良好率和死亡率差异有统计学意义(P<0.05),标准外伤大骨瓣减压手术治疗组预后明显优于常规骨瓣开颅手术组。结论标准外伤性大骨瓣内外减压手术能明显改善严重对冲性颅脑损伤病人的预后,并降低死亡率。

Clinical significance of standard large trauma craniectomy to treat the patients with severe bump brain injury

Objective To evaluate the efficacy of standard large trauma craniectomy to treat the patients with severe bump brain injury. Methods Thirty-two bump brain injured patients with cerebral hernia were treated with inside and outside decompression of standard large trauma craniectomy compared with 24 cases of routine temporoparietal craniectomy between Oct 2001 and Aug 2004.Results In standard large trauma craniectomy group,21 cases got good recovery(65.6%) and 5 were dead(15.6%).In routine temporoparietal craniectomy group,9 cases got good recovery(37.5%) and 10 were dead(41.7%).There was significant difference between the two groups in good recovery and mortality(P<0.05).The outcome of standard large trauma craniectomy group was better than that of routine temporoparietal craniectomy group.Conclusion The inside and outside decompression of standard large trauma craniectomy significantly improves the outcome of patients with severe bump brain injury and reduces the mortality.