摘要
目的 探讨标准外伤大骨瓣开颅 (StandardLargeTraumaCraniotomy)治疗重型对冲性脑挫裂伤颅内血肿的效果。 方法 对 5 8例重型对冲性脑挫裂伤患者切口始于耳前颧弓处 ,向后上方延伸至顶结正中线再转向前 ,止于额部发际下。皮瓣翻开后颅骨钻 4～ 5孔 ,分别位于额骨颧突的后方 ,额骨中线旁 ,顶骨中线旁 (距中线 2cm～ 3cm) ,颞骨下方。骨瓣大于 10cm× 10cm。骨瓣翻向颧弓后 ,向下咬除颞鳞及喋骨嵴外侧 ,使骨囱下界达中颅窝底。 2例并枕部颅内血肿切口从耳廓后向枕部延伸 ,再转向中线向前。“T”字型切开硬脑膜。术后行硬脑膜与颞肌筋膜减张缝合。 结果 治疗结果采用GOS评定标淮 ,植物生存状态 4例 ,严重残疾 6例 ,中度残疾 13例 ,恢复良好 2 1例 ,死亡 14例 ,其中GCS 3～ 5分死亡 8例 (4 0 % ) ,GCS 6～ 8分 6例 (16 % )。 结论 本组资料显示 ,标准外伤大骨瓣开颅在重型对冲性脑挫裂伤合并颅内血肿、脑肿胀的治疗中效果较显著 。
Objective To evaluate the effect of treatment for severe bump brain contusion complicating intracranial hematoma with standard large trauma craniotomy(SLTC). Methods All the 58 patients with severe bump brain contusion complicating intracranial hematoma were treated by SLTC. Results To evaluate the curative effect by using GOS,4 cases were persistent vegetative state(pvs).6 cases left severe disability,13 cases had only moderate disability,21 cases had a good recovery,14 cases died.Among the 14 cases,these were 8 cases(40%) whose score of GCS was 3～5,the other 6 cases(16%),the score of GCS was 6～8. Conclusion The SLTC was used for severe bump brain contusion complicating intracranial hematoma,the curative effect was significant.And there are also many advantages that can not be substituted by other methods.
出处
《实用心脑肺血管病杂志》
2002年第4期205-207,共3页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
