改良扩大硬膜腔颞肌下减压术治疗外伤后急性脑肿胀的临床效果观察  

作　　者：赵锦阳 陈德[1] 刘刚[1] 

机构地区：[1]九〇三医院神经外科,四川江油621700

出　　处：《世界中医药》2015年第A01期202-202,共1页World Chinese Medicine

摘　　要：目的研究分析改良扩大硬膜腔颞肌下减压术治疗外伤后急性脑肿胀的临床效果.方法：选取113 例外伤后急性脑肿胀患者,根据手术方式分为对照组（54例）与观察组（59 例）,对照组行传统去骨瓣颞肌下减压,观察组行改良扩大硬膜腔颞肌下减压术,观察两组治疗效果.结果：两组患者术后24h 颅内压与术前相比均显著下降;且观察组显著低于对照组（P〈0.01）.患者术后3 个月经CT 检查,观察组并发症发生27 例（45.8%）;对照组发生42 例（77.8%）.术后观察组并发症发生率显著低于对照组（P〈0.01）.结论：采用改良扩大硬膜腔颞肌下减压术治疗外伤后急性脑肿胀疗效显著,有利于术后控制颅内高压,减少相关并发症的发生.Objective: To study the clinical effect of improving the treatment of acute cerebral edema after traumatic brain injury with modified extended epidural space. Methods: a total of 113 cases of posttraumatic acute brain swelling in patients with as the research object, according to the operation mode, divided into control group(54 cases) and observation group(59 cases), control group received traditional bone temporalis muscle flap decompression, observation group underwent modified expanding decompression under epidural temporal muscle observed the therapeutic effect of two groups. Results: two groups of patients after surgery, 24 h intracranial pressure and compared with the preoperative were significantly decreased(P < 0.01); and the observation group of patients with intracranial pressure after surgery was significantly lower than the control group(P < 0.01). Patients three months after CT examination, observation group complications occurred in 27 cases(45.8%), including 4 cases of subcutaneous effusion, seizures in 8 cases, encephalocele in 3 cases, brain water in 5 cases, 7 cases of cerebral infarction. Control group complication occurred in 42 cases(77.8%). The postoperative complication rate was significantly lower in the observation group than in the control group(P < 0.01). Conclusion: the improved expansion of the epidural space in the treatment of acute brain swelling after trauma has a significant effect, which is conducive to the control of intracranial hypertension, reduce the occurrence of related complications.

关 键 词：减压术 改良 急性脑肿胀 外伤 

分 类 号：R651.15[医药卫生—外科学]