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目的讨标准大骨瓣开颅减压术治疗重型颅脑损伤并发脑疝的疗效。方法将33例符合手术治疗的重型颅脑损伤并发脑疝的患者行标准大骨瓣开颅减压术,术后随访6~10个月。采用GOS评判预后。结果 33例重型颅脑损伤并发脑疝病人,行标准大骨瓣开颅减压术后,经随访恢复良好15例(45.5%),中残6例(18.2%),重残3例(9.1%),植物生存2例(6.1%),死亡7例(21.2%)。结论标准外伤大骨瓣开颅减压术,具有暴露广泛,颅骨减压窗大,压力容易分散,最大限度地增加有效容积,减压充分,脑疝易复位,能明显降低脑疝病人的死亡率和病残率。
Objective To discuss the curative effect of standard large craniotomy decompression for the treatment of severe craniocerebral injury complicated by cerebral hernia. Methods Thirty-three patients with severe craniocerebral injury and hernia complicated with surgery underwent standard craniotomy decompression. The patients were followed up for 6 to 10 months. The prognosis was evaluated by GOS. Results 33 cases of severe craniocerebral injury complicated with cerebral hernia patients underwent standard craniotomy decompression. After follow-up, 15 cases (45.5%) were recovered well, 6 cases (18.2%) were disabled and 3 cases %), Plant survival in 2 cases (6.1%) and death in 7 cases (21.2%). Conclusions Standard craniotomy decompressive craniectomy with extensive exposure, large decompression window of the skull, the pressure is easy to disperse, to maximize the effective volume, decompression, hernia easy to reset, can significantly reduce the death of patients with cerebral hernia Rate and morbidity.