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目的总结重型颅脑损伤合并脑疝的救治经验并分析其预后情况。方法回顾性分析68例重型颅脑损伤合并脑疝患者的临床资料,根据不同手术方法、GCS评分与病情分别分析其预后情况。结果GCS评分3～5分患者的死亡率显著高于GCS评分6～8分患者(P＜0．05),幕上去大骨瓣减压+颅内血肿清除+小脑幕切开手术方式治疗的患者死亡率明显低于单侧幕上去大骨瓣减压+颅内血肿清除手术方式治疗的患者(P＜0．05)。结论重型颅脑损伤合并脑疝的临床疗效与GCS评分和手术方式密切相关。
Objective To summarize the experience of treatment of severe craniocerebral injury complicated with cerebral hernia and analyze its prognosis. Methods The clinical data of 68 patients with severe craniocerebral injury complicated with cerebral hernia were retrospectively analyzed. The prognosis of patients with severe craniocerebral injury were analyzed according to different surgical methods, GCS score and disease. Results The mortality rate of patients with GCS score 3 to 5 was significantly higher than that of patients with GCS score 6 to 8 (P <0.05). The treatment of large flap decompression + intracranial hematoma removal + The mortality of patients was significantly lower than that of unilateral caudal decompression + intracranial hematoma removal (P <0.05). Conclusion The clinical curative effect of severe craniocerebral injury combined with hernia is closely related to GCS score and operation method.