去骨瓣减压治疗外伤后脑水肿所致颅内高压的疗效分析  

Decompressive craniectomy for management of intracranial hypertension secondary to cerebral edema due to traumatic brain injury

作　　者：杨治荣[1] 胡锦[1] 田恒力[1] 高文伟[1] 侯立军[2] 吴小军[2] 卢亦成[2] 

机构地区：[1]上海交通大学附属第六人民医院神经外科,200233 [2]第二军医大学附属长征医院神经外科,上海市神经外科研究所

出　　处：《中华创伤杂志》2007年第10期766-768,共3页Chinese Journal of Trauma

摘　　要：目的 研究去骨瓣减压对头颅外伤后脑水肿引起的颅内压升高的治疗效果。方法 用去骨瓣减压治疗27例头颅外伤后因脑水肿引起的颅内压升高患者，根据随访情况，分析一般临床特征、去骨瓣减压的疗效及减压范围与颅压下降的关系。结果患者年龄偏小[（24．8±11．6）岁]；交通伤为主，占52％；男性居多，占74％。去骨瓣减压术后1h颅内压[（12．3±6．1）mmHg]明显低于术前[（28．4±3．2）mmHg，P〈0．01]；去骨瓣减压术后24h颅内压[（14．3±8．9）mmHg]也低于术前（P〈0．01）。减压范围与颅内压下降呈正相关。患者恢复满意率73％。结论 去骨瓣减压治疗外伤性头颅损伤后脑肿胀或脑水肿的患者疗效满意。Objective To investigate the therapeutic efficacy of deeompressive craniectomy （ DC ） in the management of intracranial hypertension secondary to cerebral edema due to traumatic brain injury （TBI）. Methods A retrospective study was performed in 27 cases of TBI treated with DC. All cases were followed up to analyze the clinical characteristics, therapeutic efficacy and possible relationship between the size of the eranieetomy and decrease of intracranial pressure （ICP）. Results All cases were at age of （24.8 ± 11.6 ） years, with males accounting for 74% and traffic injury for 52%. The mean ICP was reduced significantly from （28.4 ±3.2） mm Hg to （12.3 ±6. 1 ） mm Hg at 1 hour and （14.3 ± 8.9 ） mm Hg at 24 hours after craniectomy （P 〈 0. 01 ）. A positive correlation was found between the size of the craniectomy and decrease of ICP, The rate of satisfactory recovery was 73%. Conclusion DC can attain satisfactory effect in the management of intracranial hypertension secondary to cerebral edema due to TBI.

关 键 词：脑损伤 减压术 外科 颅内压 去骨瓣 

分 类 号：R686[医药卫生—骨科学]