控制减压治疗重型、特重型颅脑伤  

The treatment of severe and the most severely brain injury by controlled decompression

作　　者：王玉海[1] 杨理坤[1] 蔡学见[1] 朱军[1] 王剑超[1] 陈磊[1] 刘斌[1] 高泽勇[1] 孙呈国[1] 王春莉[1] 

机构地区：[1]解放军第101医院神经外科、全军颅脑损伤救治中心,江苏无锡214044

出　　处：《中华神经外科杂志》2010年第9期819-822,共4页Chinese Journal of Neurosurgery

基　　金：南京军区十一五重点课题（09Z002）

摘　　要：目的 探讨控制减压治疗重型、特重型颅脑伤的临床疗效.方法 将128例重型、特重型颅脑伤随机分成两组进行前瞻性研究,采用控制减压手术方法者为治疗组,采用常规开颅者为对照组.结果 按GOS治疗结果,治疗组良好率较对照组提高17.2%,治疗组死亡率较对照组下降12.5%;术中脑膨出的发生率治疗组较对照组下降17.2%,迟发血肿的发生率治疗组较对照组下降7.8%,因迟发血肿引起的术中脑膨出治疗组较对照组下降12.5%（P＜0.05）.结论 控制减压通过颅内压力的逐步释放,降低或延缓了因颅内迟发血肿引起的术中急性脑膨出,对改善重型、特重型颅脑创伤患者的预后起到了积极的救治作用.Objective To investigate the clinical effects of severe brain injury by controlled decompression. Method A total of 128 cases of severe and the most severely brain injuries are divided into two groups randomly and analyzed by prospectively. Results By Glasgow Outcome Scale（GOS）, the good recovery rate of treatment group was 17. 2% higher than the control group,and death rate was 12. 5% lower than the control group. The rate of intraoperative brain swelling in treatment group was 17. 2% lower than the control group,and the incidence rate of delayed hematoma was 7. 8% lower than the control group. The rate of intraoperative brain swelling by delayed hematoma in treatment group was 12. 5% lower than the control group（P 〈 0. 05）. Conclusions The operation by controlled decompression can reduce or delay the arising of intraoperative brain swelling by delayed hematoma and improve the prognosis of severe brain injuries.

关 键 词：颅脑损伤 控制减压 术中颅内压监测 迟发血肿 术中脑膨出 

分 类 号：R651.15[医药卫生—外科学]