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目的探讨梯次减压术治疗急性硬膜下血肿并脑疝的临床效果。方法将40例急性硬膜下血肿并脑疝患者随机分为治疗组和对照组,治疗组行梯次减压术,对照组行常规骨瓣开颅术,术后护理方法相同,术后随访6个月,进行GOS预后评分。结果治疗组术中出现急性脑膨出2例,对照组出现8例;术后6个月GOS评分,治疗组预后良好(65.00%),情况明显优于对照组(30.00%,P<0.05),死亡率(10.00%)明显低于对照组(45.00%,P<0.05)。结论梯次减压可实现颅内压逐步减压,避免了既往开颅手术直接打开硬脑膜减压过快、过快解除填塞效应而导致急性脑膨出的发生,能进一步改善预后。
Objective To investigate the clinical effect of echelon decompression in the treatment of acute subdural hematoma and cerebral hernia. Methods Forty patients with acute subdural hematomas and cerebral hernias were randomly divided into treatment group and control group. The treatment group received erection decompression and the control group received conventional craniotomy. The methods of postoperative nursing were the same and were followed up for 6 Month, GOS prognostic score. Results There were 2 cases of acute encephalocele in the treatment group and 8 cases in the control group. The GOS score of 6 months after operation was good (65.00%) in the treatment group, which was significantly better than that of the control group (30.00%, P <0.05) , The mortality rate (10.00%) was significantly lower than that of the control group (45.00%, P <0.05). Conclusions The decompression of the eyelid can reduce the pressure of the intracranial pressure gradually and avoid the occurrence of acute encephalocele caused by the direct decompression of the dura directly by opening the craniotomy, relieving the packing effect too fast, and further improving the prognosis.