额叶脑挫裂伤的治疗分析  

Therapeutic analysis of frontal lobe brain contusion

作　　者：郑烈辉[1] 李作士[1] 孙勤鑫[1] 

机构地区：[1]广东揭阳市人民医院神经外科,揭阳515500

出　　处：《实用神经疾病杂志》2005年第5期13-15,共3页

摘　　要：目的探讨额叶脑挫裂伤合理的治疗方法及手术指征。方法对110例额叶脑挫裂伤患者的临床资料进行回顾性或前瞻性分析,其中保守治疗32例;手术治疗78例:设计组24例采用大骨瓣开颅术后额骨部分回覆改良减压治疗额叶挫裂伤;对照组26例采用额部单纯去骨瓣减压术。结果保守治疗死亡率22%,手术治疗死亡率14%。设计组24例治疗结果,其并发症、治愈率及伤残率明显优于对照组(P<0·05)。结论前额叶脑挫裂伤临床特点似缓而急,早期积极主动的手术治疗能提高抢救成功率,降低恶化率;采用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效果最佳。Objective To investigate the operative indication and reasonable tberapeutie methods of frontal lobe contusion. Methods Clinical data and following up materials comparative analysis of 110 eases frontal lobe brain eontusion had been done in both retrospecive and prospective studies. Among them, 32 cases used eonservative therapy, while 78 eases used operative therapy, the later group ineluding four operative methods, 50 cases optional divided into two groups under perspective comparative analysis, 24 cases of design group used big bone flap eraniotomy and partly recovery of frontal bone modified decompression, 13 cases ehoose miemtraumatie eraniotomy then use catheterized inject urokinase to brush and lysis drainage as the third method , 13 eases ehoose other operative methods, Results Mortality rate is 22% in conservation group, while operative therapeutie group only 14%, compare with eontrol group, 24 cases of design group was better in eomplieation rate, eure rate and disable rate （P 〈 0.05）. Conclusion Clinieal characteristic of frontal lobe eontusion looks slow but actually acute, early aetive operative therapy care can improve suecess rate and better than eonservative group in perspective study. The best method is ehoosing big bone flap eraniotomy and partly recovery of frontal bone modified decompression in the therapy of frontal lobe contusion.

关 键 词：额叶脑挫裂伤 手术治疗 大骨瓣开颅术 额骨部分回覆减压术 去骨瓣减压术 

分 类 号：R651.15[医药卫生—外科学]