标准外伤大骨瓣减压救治脑疝病人的临床应用  

Standard decompressive craniectomy with large bone flap resection for traumatic brain injure patients with brain herniation

作　　者：王洪正[1] 戴黎萌[2] 许燕球[1] 陈建良[2] 吴耀晨[2] 徐如祥[3] 

机构地区：[1]广东省惠州市惠阳区第一人民医院神经外科,516211 [2]广东省深圳市人民医院神经外科,518020 [3]南方医科大学珠江医院神经外科,广州510282

出　　处：《中华神经医学杂志》2005年第10期1037-1039,共3页Chinese Journal of Neuromedicine

摘　　要：目的探讨应用标准外伤大骨瓣减压救治脑疝病人的疗效。方法对105例外伤性脑疝病人施以标准外伤大骨瓣减压术,全部病人均进行随访,按GOS评分法判断预后。结果术后3个月至半年随访,恢复良好20例,中残19例,重残22例,植物生存18例,死亡26例。死亡者中45岁以上者为9例,45岁以下者17例。入院时为脑疝者63例,术后死亡20例;入院后逐渐出现脑疝者42例,术后死亡6例。脑疝发生后2h内手术者89例,死亡17例;大于2h手术者16例,死亡9例。结论及早、彻底地施行标准外伤大骨瓣减压能明显提高脑疝病人的疗效及降低死亡率。Objective To probe into the curative effect of standard large decompressive craniectomy for traumatic brain injure patients with herniation. Methods Standard large decompressive craniectomy was performed on 105 patients with traumatic brain herniation. The curative effect was assessed according to GOS. All postoperative patients were followed up for 3-6 months. Results According to the GOS, 20 cases recovered well, 19 cases became moderately disabled, 22 cases were severely disabled, 18 cases was in vegetative state and 26 cases died. In the dead patients, 9 cases were older than 45 years, 17 cases younger than 45 years. After operation, 20 cases died among the traumatic brain injure patients who showed herniation when admitted into the hospital ; 6 cases died among the patients who gradually showed herniation after admitted into the hospital. In the 89 patients who underwent the operation within 2 h after herniation, 17 cases died. In the 16 cases who underwent the operation beyond 2 h after herniation, 9 cases died. Condusion Timely and thoroughly standard decompressive craniectomy with large bone flap resection for traumatic brain injure patients with herniation can significantly improves the curative effect of the patients, and can help to lower mortality rate and to improve patients＇ living quality.

关 键 词：脑疝 外科手术 大骨瓣减压 

分 类 号：R651.1[医药卫生—外科学]