大骨瓣减压治疗重型颅脑损伤疗效分析
Journal of Emergency Medicine(2005)
Abstract
目的探讨大骨瓣减压比较常规骨瓣减压治疗重型、特重型颅脑损伤的疗效和优势。方法回顾性分析本科近年收治的263例重型颅脑损伤(GCS≤8分)患者,治疗组135例[含特重治疗组(GCS≤5分)54例]采用标准大骨瓣开颅术减压,对照组128例(含特重对照组49例)采用常规骨瓣减压。术后6个月,比较GOS评定和并发症。结果治疗组有效96例(71.1%),对照组为75例(58.6%),P<0.05;特重治疗组有效34例(63%),特重对照组为18例(36.7%),P<0.01。治疗组在术后因继发颅内高压而再次手术的发生率低于对照组(P<0.05),但术后迟发血肿和对侧硬膜下积液发生率多于对照组(P<0.05)。结论大骨瓣减压治疗重型,尤其是特重型颅脑损伤,能提高治疗效率;减少因继发颅内高压而再次手术的发生;但术后迟发血肿和对侧硬膜下积液增多。
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Key words
Large decompressive craniectomy,Complication,Severe traumatic brain injury
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