摘要
目的研究颅脑损伤合并骨折脱位的治疗方法及手术时机.方法通过对我院从1995年1月至2004年12月收治的109例颅脑损伤合并骨折脱位患者的治疗方法及结果进行回顾性分析.结果开颅手术58例(53.21%),急诊手术51例,气管切开35例(32.11%),亚低温治疗29例(26.61%);骨折脱位开放复位术49例(44.95%),内固定45例,开颅手术与骨折清创术同时进行4例,急诊手术12例,其余手术均在伤后2～3周内进行,关节脱位全部及时手法复位.颅脑损伤愈合优良率82.57%,病死率9.17%;骨折愈合率84.40%,延迟愈合4.59%,骨不连1.83%.结论颅脑损伤合并骨折脱位的治疗除及时开颅、保持呼吸道通畅外,适时进行去骨瓣减压术、亚低温治疗及尽早予以高压氧治疗能明显减轻(少)后遗症和降低死亡率;骨折仅少部分需手术复位、内固定,在伤后2～3周内手术,无需植骨.
Objective To study the therapeutic method and operation opportunity of head injury merge fracture dislocation. Methods The therapeutic method and result were retrospectively analysed to 109 patients with head injury merge fracture dislocation in people＇s hospital of Guangyuan city form January 1995 to December 2004. Results Craniotomy was performed in 58 cases （53.21 % ）, emergency operation was performed in 51 cases, tracheotomy was performed in 35 cases （32.11% ）, hypothermia treatment was performed in 2~ cases （26.61%）. Open reduction was performed of fracture dislocation in 49 cases （44.95 %）,internal fixation was performed in 45 patients, craniotomy and fracture debridement was performed in 4 cases at the same time, Emergency operation was performed in 12 cases, and the remainder was on in the 2 - 3 week after the injury. All of the abarticulation give the manipulative reductive in time. The excellent and good results were seen in 82.57 % （90/109） of the head injury, mortality 9.17 % （ 10/109 ） . The fracture union rate was 84.40 % （92/109） of the case, delayed union 4.95 % （ 5/109 ）, and two cases （ 1.83 % ） went on non- union of fracture. Conclusion The treatment of head injury merge fracture dislocation, in addition to betimes craniotomy and keeping to breathe unobstructed, as early as possible craniectomy decompression, hypethermia treatment, and hyperbaric oxygen can obviously reduce the sequela and the mortality. The only minority of fracture needs the operation reduction, and internal fixation, within 2 - 3 week is carries on after the wound, the bone grafting is contraindicate.
出处
《四川医学》
CAS
2005年第11期1225-1226,共2页
Sichuan Medical Journal
关键词
颅脑损伤
骨折脱位
治疗
Head injury
Fracture dislocation
Treatment
