控制减压策略在去骨瓣减压术治疗重、特重度颅脑损伤的临床应用  

The clinical study of the treatment of severe or extra-severe craniocerebral injuries by stepped decompression strategy

作　　者：葛键[1] 王维东[1] 汤德刚[1] Ge Jian Wang Weidong Tang Degang(The First People＇s Hospital of Chuzhou City ,Anhui Province, 239000, Chin)

机构地区：[1]安徽省滁州市第一人民医院神经外科,滁州市239000

出　　处：《立体定向和功能性神经外科杂志》2016年第3期172-174,共3页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的探讨阶梯减压策略在去骨瓣减压术治疗重、特重度颅脑损伤的应用价值。方法收集2013年1月至2015年9月重、特重度颅脑损伤患者41例,采用阶梯减压的去骨瓣减压术式治疗,统计术中急性脑膨出发生率、术后再出血发生率、平均手术时间、和术后6个月预后情况。结果 41例患者发生术中急性脑膨出发生4例(9.76%),术后再出血发生3例(7.32%),平均手术时间(4.246±1.219)h,术后6个月预后良好18例(43.90%),预后不良23例(56.10%)。结论阶梯减压策略治疗重度、特重度颅脑损伤患者,在不增加总的手术时间的情况下,可以降低患者术中急性脑膨出、术后再出血的发生率,改善预后,适合临床使用。Objective To discuss the effect of the treatment of severe or extra-severe craniocerebral injuries by stepped decompression.Methods Admitted into 41 severe or extra-severe craniocerebral injuries patients of the First People’s Hospital of Chuzhou from Jan 2013 to Sept 2015,who were treated with decompressive craniectomy with stepped decompression strategy,and then analyzed the incidence of intra-operative acute encephalocele,the incidence of recurrent postoperative hemorrhage,the mean operative time and postoperative prognosis in six-month.Results In this study,the incidence of intra-operative acute encephaloceleThere was 9.76%（4/41）,the incidence of recurrent postoperative hemorrhage was 7.32%（3/41）,the mean operative time was（4.246±1.219）h,and there were 18cases（43.90%）had a good postoperative prognosis in six-month,while 23cases（56.10%）did not.Conclusion The treatment of severe or extra-severe craniocerebral injuries by stepped decompression strategy could reducing the incidence of intra-operative acute encephalocele and recurrent postoperative hemorrhage,and improve the prognosis,while did not increasing the operation time,which was worth clincal application.

关 键 词：阶梯减压策略 去骨瓣减压术 颅脑损伤 预后 

分 类 号：R651[医药卫生—外科学]