合页式骨瓣减压的临床应用探讨  

Clinical use of hinge craniotomy for cerebral decompression

作　　者：李志强[1] 焦铁鹰 夏吉勇[1] 苗林[1] 任雅盼 贾文清[2] Li Zhiqiang;Jiao Tieying;Xia Jiyong;Miao Lin;Ren Yapan;Jia Wenqing(Department of Neurosurgery,Mentougou District Hospital,Beijing 102300,China;不详)

机构地区：[1]北京市门头沟区医院神经外科,102300 [2]首都医科大学附属北京天坛医院神经外科

出　　处：《中国药物与临床》2020年第23期3896-3898,共3页Chinese Remedies & Clinics

摘　　要：目的探讨合页式骨瓣减压的临床可行性。方法符合去除骨瓣减压指征的患者58例,分为2组,试验组28例行合页式骨瓣开颅,对照组30例行标准去大骨瓣减压术。比较2组颅内压,并发症及术后6个月格拉斯哥预后评分(GOS)情况。结果试验组未出现脑膨出病例,对照组出现不同程度的脑膨出患者8例。试验组死亡5例,对照组死亡6例。2组随访6个月以上者共28例,试验组病例骨瓣无外凸或下陷。2组患者颅内压、随访6月GOS比较差异无统计学意义(P>0.05)。结论合页式骨瓣减压在减压效果方面与标准去大骨瓣手术相近似,能避免二次颅骨修补术、有效减少术后并发症。Objective To investigate the clinical feasibility of hinge craniotomy for cerebral decompression.Methods Fifty-eight patients who fulfilled the indications for decompressive craniectomy were divided into two groups.The study group(n=28)underwent hinge craniotomy for cerebral decompression,and the control group(n=30)underwent traditional decompressive craniectomy.The intracranial pressure,complications and Glascow outcome score(GOS)at six months after the operation in the two groups were compared.Results There was no case of encephalocele in the study group,whereas there were 8 cases with different degrees of encephalocele in the control group.Five patients in the study group and 6 in the control group died.A total of 28 cases were followed up for more than 6 months in the 2 groups.There were no bulging or sinking bone flaps in the study group.There were no statistically significant differences in the intracranial pressure and GOS at 6 months after follow-up between the two groups(both P>0.05).Conclusion The effect of hinge craniotomy for cerebral decompression is similar to that of traditional decompressive craniectomy,but it avoids secondary cranioplasty,and thereby effectively reduces postoperative complications.

关 键 词：合页式骨瓣 去骨瓣减压术 外科 颅内压 

分 类 号：R651.15[医药卫生—外科学]