大骨瓣减压术在重型颅脑损伤治疗中应用探讨

目的探讨大骨瓣减压术在重型颅脑损伤治疗中的应用。方法治疗组选择重型颅脑损伤后难治性颅内高压36例,采用大骨瓣减压术;对照组选择前期重型颅脑损伤后难治性颅内高压19例,采用传统骨瓣减压术及保守治疗。比较两组病例疗效,并比较不同时期大骨瓣减压术疗效。结果两组间疗效评价采用出院时GOS评定,显示二组间有明显差别(P<0.05),且治疗组早期手术疗效优于晚期手术疗效(P<0.05)。结论早期大骨瓣减压术在治疗重型颅脑损伤后难以控制颅内高压是有效的。

Application of decompressive craniotomy with extensive bone resection in the treatment of severe traumatic brain injuries

Objective To explore the application of decompressive craniotomy with extensive bone resection in the treatment of severe traumatic brain injuries. Methods 36 cases with refractory intracranial hypertension after severe traumatic brain injuries as a treatment group were managed with decompressive craniotomy with extensive bone resection. 19 cases with refractory intracranial hypertension appearing at the early stage of severe traumatic brain injuries as a control group were treated with traditional decompressive craniotomy and conservative therapy. The comparison was made in the therapeutic efficacy of decompressive craniotomy with extensive bone resection performed at the early and later stages. Results Post-operative GOS were measured for comparing the therapeutic efficacy between the two groups. There was statistical significant difference between the two groups(P<0.05). The GOS evaluation was better in the patients undergoing the operation at the early stage than those at the later stage. Conclusion The application of decompressive craniotomy with extensive bone resection in the treatment of refractory intracranial hypertension after severe traumatic brain injuries in early stage can lead to a better clinical rehabilitation.