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目的分析无明显中线结构移位的重型颅脑损伤患者的治疗方案及预后。方法 35例无明显中线结构移位的重型颅脑损伤患者,依病情采取保守治疗和手术治疗,8例患者采用非手术治疗,包括控制颅内高压,防止脑水肿及各种并发症治疗。12例患者采用单侧标准大骨瓣减压术,其中4例同时行内减压术,1例行小脑幕切开术。5例患者采用冠状开颅去骨瓣减压术。10例患者行双侧标准大骨瓣减压术。观察患者预后。结果 35例患者恢复良好12例,中残10例,重残6例,植物生存状态4例,死亡3例。结论无明显中线结构移位的重型颅脑损伤患者病情重,预后差,积极采取有效治疗手段能降低死亡率,改善预后。
Objective To analyze the treatment and prognosis of patients with severe craniocerebral injury without obvious midline structural displacement. Methods A total of 35 patients with severe craniocerebral trauma who had no obvious shift of midline were treated conservatively and surgically according to their condition. Eight patients were treated by non-surgical treatment, including controlling intracranial hypertension and preventing cerebral edema and various complications. Twelve patients underwent unilateral standard decompressive craniectomy, of which 4 underwent simultaneous decompression and 1 underwent cerebellar incision. Five patients underwent craniotomy with decompressive craniectomy. Ten patients underwent bilateral standard large-flap decompression. Observe patient’s prognosis. Results 35 patients recovered well in 12 cases, 10 cases of moderate disability, 6 cases of severe disability, 4 cases of plant survival and 3 cases of death. Conclusions Patients with severe craniocerebral injury without obvious midline structure displacement have severe illness and poor prognosis. Active and effective treatment can reduce mortality and improve prognosis.