大骨瓣开颅术后额骨部分回覆改良减压治疗额叶脑挫裂伤  

Use partial recovery of frontal bone flap and modification decompression in the therapy of frontal lobe contusion after big bone flap craniotomy

作　　者：郑烈辉[1] 李作士[1] 蔡少明[1] 黄正华[1] 黄伟鹏[1] 

机构地区：[1]揭阳市人民医院神经外科,广东揭阳522000

出　　处：《中国基层医药》2005年第8期1043-1045,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨大骨瓣开颅术后额骨部分回覆形成翼点大骨瓣减压治疗额叶脑挫裂伤的临床效果。方法本院7年来对50例额叶脑挫裂伤并脑内血肿的病例随机分为两组,设计组24例采用大骨瓣开颅术后额骨部分回覆形成翼点大骨瓣减压治疗额叶脑挫裂伤的方法;对照组26例采用额部开颅单纯额骨瓣减压术。所有患者均采用统一选择标准,无明显差异。结果两组病例在治疗过程及在伤后12个月的临床随访结果显示:设计组在治愈率、伤残率及各种并发症发生率均明显优于对照组(P<0·05)。结论设计组在手术时除能够在直视下彻底清除血肿及失活脑组织外,尚能较快促进脑疝的恢复,及时解除脑组织对脑干的压迫,更好地缓解脑肿胀,保证脑组织血液的有效灌流,缩短脑水肿时间,从而缩短病程时间、减少并发症,较高提高生存质量。Objective To investigate the clinical effect of big bone flap craniotomy of partial recovery frontal bone flap and pterion point big bone flap decompression in the therapy of frontal lobe contusion. Methods 50 cases of frontal lobe brain contusion combined with intra-cranial hematoma in our hospital during recent 7 years were optionally divided into two groups. Experimental group including 24 cases were performed parital recovery of frontal bone and pterion point of bone flap decompression after big bone flap craniotomy in the therapy of frontal lobe brain contusion,26 cases of control group were given frontal craniotomy and simple frontal bone flap decompression. All the patients used the same selective standard without conspicious variation. Results In the process of therapy and twelve months clinical follow up after injury, the experimental group was better than the control group in cure rate, disable rate and complication rate（P 〈0.05）. Conclusion Experimental group can clean up hematoma and dead brain tissue under direct vision during operation and promote recovery of brain hernia faster and relax pressure of brain tissue to brain stem and also diminish brain swelling, guarantee blood supply to brain tissue effectively, shorten the duration of brain edema, diminish complications and better improve life quality.

关 键 词：脑出血 创伤性 移植物 减压术 外科 脑挫裂伤 开颅术后 减压治疗 大骨瓣 额叶 额骨 并发症发生率 

分 类 号：R651[医药卫生—外科学]