改良标准外伤大骨瓣开颅术治疗脑疝形成的重型颅脑外伤  

Modified standard large trauma craniotomy for treating severe traumatic head injury accompanied by herniation of brain

作　　者：李军[1] 胡国清[1] 赵飞[1] 孙家和[1] 宋怡诚[1] 

机构地区：[1]合肥市第一人民医院脑外科,230061

出　　处：《安徽医学》2005年第2期108-109,共2页Anhui Medical Journal

摘　　要：目的　介绍一种改良标准外伤大骨瓣开颅术在治疗脑疝形成的重型颅脑外伤中的应用。方法　采用改良标准外伤大骨瓣开颅术治疗 18例脑疝形成的重型颅脑外伤 ,改良之处在于皮瓣走行 ,丢弃的骨瓣大小 ,病灶清除后减张缝合硬膜。结果　 18例中恢复良好 10例 ,中残 1例 ,重残 1例 ,植物生存 2例 ,死亡 4例 ,病死率 2 2 %。结论　采用改良标准外伤大骨瓣开颅术是治疗脑疝形成的重型颅脑外伤有效方法 ,与标准外伤大骨瓣开颅术比较具有皮瓣设计更合理 ,减少了外减压的盲目性 ,一定程度上减少了并发症。Objective To introduce the clinic application of modified standard large trauma craniotomy for treating severe traumatic head injury.Methods 18 cases developed into the herniation of brain were treated with modified standard large trauma craniotomy, the difference lies in the planning incisions, the location of removing bone flap and suturing the dura relaxedly after operation.Results Healing:10 cases; moderate disablity:1 case; severe disability:1 case; vegetative state: 2 cases,; death: 4 cases. The mortality rate was 22%.Conclusion Modified standard large trauma craniotomy for treating severe traumatic head injury developed into herniation of brain is a preferable operative means, which has an rational planning incision and reduce the blindness of outer decompression and the complications to a degree.

关 键 词：治疗 标准外伤大骨瓣开颅术 脑疝形成 重型颅脑外伤 改良 并发症 皮瓣设计 植物 盲目性 缝合 

分 类 号：R651.1[医药卫生—外科学]