双额叶重度脑挫裂伤并发中央型脑疝的手术治疗

目的 探讨双额叶重度脑挫裂伤并发中央型脑疝的手术治疗.方法 48例双额叶重度脑挫裂伤并发中央型脑疝患者,根据CT结果及临床表现,选择手术时机,应用单侧去骨瓣减压术或双侧去骨瓣减压术治疗.结果 术后随访1年,存活42例,死亡6例；根据GCS评分评价疗效:良好18例(37.5％),轻残16 例(33.3％),重残5例(10.4％),植物生存3例(6.3％),死亡6例(12.5％).结论 双侧额叶重度脑挫伤患者病情进展快,尽早诊治可有效改善患者预后.

Surgery for the patients with bruise of bilateral frontal lobes complicated with central encephalocele

Objective To discuss the surgery for the patients with bruise of bilateral frontal lobes complicated with central encephalocele. Methods 48 patients diagnosed as bruise of bilateral frontal lobes complicated with central encephalocele were analyzed retrospectively. According to the results of CT and clinical symptoms, timing of surgery was selected. All patients were given unilateral decompressive cranieetomy or bilateral decompressive craniectomy. Results All patients were followed up for 1 year. 42 cases survived, while 6 cases died. All cases were estimated with GCS： 18 cases （ 37.5% ） were cured excellently, 16 cases （ 33. 3% ） were mild morbidity, 5 cases （10.4%） were severe morbidity, 3 cases （6.3%） were in persistent vegetative state and 6 cases （ 12.5% ） were dead. Conclusion The progression of patients with bruise of bilateral frontal lobes complicated with central encephalocele were rapid. Diagnosis and treatment at the early stage could improve patients＇ prognosis.