标准外伤大骨瓣减压救治脑疝患者的临床应用  

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

作　　者：严畅[1] 周钟阳[1] 苏杰[1] 温振东[1] 

机构地区：[1]安徽省蚌埠市第三人民医院神经外科,233000

出　　处：《淮海医药》2008年第5期387-389,共3页Journal of Huaihai Medicine

摘　　要：目的探讨应用标准外伤大骨瓣减压救治脑疝患者的疗效。方法对42例外伤性脑疝患者施以标准外伤大骨瓣减压术,全部患者均进行随访,按GOS评分法判断预后。结果存活33例（78.5%）,死亡9例（21.5%）。术前GCS评分6～8分30例,术后存活26例,死亡4例。术前GCS评分3～5分12例,存活7例,死亡5例。术后3～6个月随访,恢复良好22例,中残6例,重残3例,植物生存2例。结论施行标准外伤大骨瓣减压能明显提高脑疝患者的疗效及降低死亡率。Objective To probe into the curative effect of standard deeompressive eranieetomy for traurnatie brain injured patients with herniation. Methods Standard large bone flap deeompressive eranieetomy was performed on 42 patients with traumatic brain herniation. The curative effect was assessed according to GOS. All postoperative patients were followed up for 3 ～ 6months. Results Thirty-three eases （78. 5% ） were alive and 9 eases（21.5% ） dead. Twenty-six eases remained alive and 4 eases died in terms of those with a score of 6 ～ 8 on GCS. Seven eases stayed alive and 5 eases were dead for those with a score of 3 ～ 5 on GCS. According to the GCS ,22 eases recovered well,6 eases became moderately disabled,3 eases were severely disabled and 2 eases were in vegetative state. Conclusion Standard deeompressive eranieetomy with large bone flap resection for traumatic brain injurd patients with herniation can significantly improve the curative effect of the patients, and can help to lower mortality rate and to improve patients＇living quality.

关 键 词：脑疝 颅脑损伤 减压术 外科 

分 类 号：R651.15[医药卫生—外科学]