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目的总结急性颅脑损伤患者的外科手术治疗效果。方法2005年1月-2009年5月,急诊外科行手术治疗158例急性颅脑损伤患者。其中男89例,女69例;年龄5～84岁,平均40岁。受伤至入院时间为1～14h,平均6h。CT诊断后行开颅血肿清除手术61例,开颅血肿消除及去骨瓣减压73例,钻孔引流术8例,气管切开14例,胸腔闭式引流术2例。结果158例共存活137例(86.7%),死亡21例(13.3%)。存活患者中植物生存2例,重度残疾18例,轻度残疾57例,恢复良好60例。死亡患者>65岁有15例;死亡时间1周内12例,1～3周内5例,3周以上4例。结论应深入了解急性颅脑损伤的特点,采取正确的手术治疗方式,积极防治并发症,降低患者死亡率,改善预后。
Objective To summarize the surgical treatment of patients with acute craniocerebral injury. Methods From January 2005 to May 2009, 158 patients with acute craniocerebral injury underwent surgical treatment in emergency department. Including 89 males and 69 females; aged 5 to 84 years, mean 40 years. Injury to admission time was 1 ~ 14h, an average of 6h. Sixty-one patients underwent craniotomy and hematoma resection, 73 patients underwent craniotomy and craniectomy, 8 underwent drilling and drainage, 14 underwent tracheotomy, and 2 underwent closed thoracic drainage. Results 158 cases of coexistence 137 cases (86.7%), 21 patients died (13.3%). Survival patients in 2 cases of plant survival, severe disability in 18 cases, mild disability in 57 cases, 60 cases recovered well. Death patients> 65 years old in 15 cases; 12 deaths within 1 week, 1 to 3 weeks in 5 cases, more than 3 weeks in 4 cases. Conclusions The characteristics of acute craniocerebral injury should be deeply understood, and the correct surgical treatment should be taken to prevent and treat complications, reduce the mortality and improve the prognosis.