标准外伤大骨瓣开颅术治疗天幕疝  

A clinical study on standard large trauma decompression craniectomy for treating transtentorial herniation

作　　者：罗新民 高玉松 刘正义 张亚东 

机构地区：[1]159医院神经外科,河南驻马店463008

出　　处：《实用医药杂志》2007年第4期406-407,409,共3页Practical Journal of Medicine & Pharmacy

摘　　要：目的评价标准外伤大骨瓣减压手术治疗天幕疝的疗效。方法76例额颞顶颅内血肿及脑挫伤致脑疝形成的颅脑损伤患者采用标准外伤大骨瓣开颅减压手术治疗,并与同期收治的72例常规骨瓣开颅手术组进行比较。结果标准外伤大骨瓣减压手术治疗组76例中,恢复良好42例,中残11例,重残8例,植物生存3例,病死12例;常规骨瓣开颅手术组72例中,恢复良好15例,中残12例,重残10例,植物生存5例,病死30例。两组对比,疗效存在显著性差异(P<0.05)。结论标准外伤性大骨瓣开颅减压手术能明显改善额颞顶颅内血肿及脑挫伤致脑疝的颅脑损伤患者的预后,并降低病死率。Objective To evaluate the efficacy of standard large trauma decompression craniectomy for treating transtentorial herniation. Methods The 148 patients with transtentorial herniation secondary to cerebral contusions and frontotemporalparietal intracephalic hematoma were divided into two groups： standard large trauma decompression craniectomy group （n=76,as A group） and routine temporoparietal craniectomy group （n=72,as B group）.The efficacy was compared between the two groups.Results Among 76 of A group 42 cases became good;ll were moderate deficit, 8 severe deficit,3 persistent vegetative status and 12 died. Among 72 of B group 15 cases obtained good recovery, 12 moderate deficit, 10 severe deficit,5 persistent vegetative status and 30 died. The outcome of A group was significantly better than that of B group （P〈0.05）.Conclusion Standard large trauma decompression craniectomy could significantly improve outcome of brain injured patients with transtentorial herniation secondary to cerebral contusions and frontotemporalparietal intracephalic hematoma and decrease the dead rate due to the disease.

关 键 词：脑疝 减压术 颅骨切开术 

分 类 号：R651.11[医药卫生—外科学]