控制性颅内减压治疗重型颅脑损伤  

Echelon Controlled Decompression Surgery for Severe Craniocerebral Injury

作　　者：门东海[1] 许成杰[1] 梁远生[1] 谈山峰[1] 刘焕强[1] 李文生[1] 林亨[1] 董虹廷 

机构地区：[1]广东医学院附院神经外科,广东湛江524001

出　　处：《贵阳医学院学报》2015年第9期969-971,共3页Journal of Guiyang Medical College

摘　　要：目的：探讨控制性颅内减压手术治疗重型颅脑损伤的临床疗效。方法：74例重型颅脑损伤患者为治疗组,使用控制减压手术治疗;72例同类患者作为对照组,采用常规标准大骨瓣开颅减压手术治疗,比较两组并发症发生率,术后3个月按照格拉斯哥预后评分（GOS）评估预后。结果：治疗组急性脑膨出、原血肿增大、迟发颅内血肿发生率及二次手术率低于对照组,两组比较差异均有统计学意义（P〈0.05）;治疗组GOS 4~5分患者比例高于对照组,差异有统计学意义（P〈0.05）。结论：控制减压手术方法明显降低了术中脑膨出的发生率,对改善重型颅脑损伤患者预后起到了积极作用。Objective： To explore the clinical effects of echelon controlled decompression surgery in severe craniocerebral injury. Methods： Seventy-four patients with severe craniocerebral injury served as the treatment group with the echelon controlled decompression surgery as treatment method. Another 72 patients of severe craniocerebral injury were chosen as control group with the regular and standard big bone flap craniotomy decompression surgery as treatment method. Incidences of complications were compared between the two groups. Prognostic assessment was conducted with GOS standards in three months after surgery. Results： The intraoperative brain swelling rate, original hematoma enlargement rate, delayed hematoma occurrence rate, secondary surgery rate of the treatment group were lower than those in control group （ P 〈 0. 05 ）. Proportion of patients with GOS scores between 4 and 5 in treatment group was higher than that in control group. Conclusions： The echelon controlled decompression surgery helps to reduce the intraoperative brain swelling rate and plays a positive role in improving the prognosis of patients with severe craniocerebral injury.

关 键 词：颅脑损伤 减压术 外科 手术中并发症 术后并发症 

分 类 号：R651.15[医药卫生—外科学]