大骨瓣减压术治疗特重型颅脑损伤疗效观察  

Clinical Study of Standard Large Trauma Craniotomy on very Severe Brain Injury

作　　者：胡观成 龚美慈 屈家虎 全兴云 许军 

机构地区：[1]湖南省张家界市人民医院神经外科 [2]湖南省张家界市人民医院麻醉科

出　　处：《实用全科医学》2007年第3期235-236,共2页Applied Journal Of General Practice

摘　　要：目的探讨标准外伤大骨瓣减压术治疗特重型颅脑损伤的临床疗效。方法对2002年1月-2006年1月采用标准外伤大骨瓣减压术治疗的68例特重型颅脑损伤患者的临床资料进行回顾性分析,术后按格拉斯哥预后评分判定疗效。结果评分结果良:好5例,中残13例,重残18例,植物状态生存4例,死亡28例;病死率为41.2%。结论特重型颅脑损伤患者应尽早清除颅内血肿,行标准外伤大骨瓣减压可提高特重型脑损伤的疗效,扩大缝合硬脑膜可降低手术并发症。Objective To evaluate the value of standard large trauma craniotomy in very sever brain injury. Methods 68 patients with very sever brain injury were treated by standard large trauma craniotomy. Based on GCS,the clinical curative effect of these patients during 3 to 6 months after operation were evaluated. Results 5 cases recovered well, 13 cases suffered from moderate disability, 18 cases remained severe disability,4 cases suffered from persistent vegetative state and 28 cases（41.2% ） died. Conclusions The prognosis of most very sever brain injury patients with GCS 3 -5 can be improved by early evacuation of intracranial hematoma with standard large trauma craniotomies. The surgical complications can be decreased by intraoperatlve enlarged duarplasty.

关 键 词：特重型颅脑伤 标准大骨瓣开颅术 疗效 

分 类 号：R651.15[医药卫生—外科学]