CAJ | 학술논문

目的回顾性探讨大骨瓣开颅颞肌下减压术在救治创伤性重型颅脑损伤伴脑梗死中的疗效.方法将48例重型颅脑损伤伴脑梗死患者按随机数字表法均分为两组,治疗组采用大骨瓣开颅减压手术；对照组采用常规开颅血肿清除术.比较分析两组患者术前、术后1d、1周脑梗死面积变化；两组患者术后3个月疗效.结果两组患者在术前、术后1d内脑梗死面积比较差异无统计学意义；术后1周,治疗组患者脑梗死面积明显小于对照组(P＜0.05).术后3个月,治疗组的死亡率为21％,显著低于对照组33％(P＜0.05)；治疗组的中残/良好率为42％,显著高于对照组25％(P＜0.05).结论大骨瓣开颅术治疗重型颅脑损伤伴脑梗死效果显著,对降低伤残与死亡率有着十分重要的意义.
목적 회고성탐토대골판개로섭기하감압술재구치창상성중형로뇌손상반뇌경사중적료효.방법 장48례중형로뇌손상반뇌경사환자안수궤수자표법균분위량조,치료조채용대골판개로감압수술；대조조채용상규개로혈종청제술.비교분석량조환자술전、술후1d、1주뇌경사면적변화；량조환자술후3개월료효.결과 량조환자재술전、술후1d내뇌경사면적비교차이무통계학의의；술후1주,치료조환자뇌경사면적명현소우대조조(P＜0.05).술후3개월,치료조적사망솔위21％,현저저우대조조33％(P＜0.05)；치료조적중잔/량호솔위42％,현저고우대조조25％(P＜0.05).결론 대골판개로술치료중형로뇌손상반뇌경사효과현저,대강저상잔여사망솔유착십분중요적의의.
Objective To retrospectively review the efficacy of large craniotomy with subtemporal decompression in the treatment of severe craniocerebral injury combined with cerebral infarction.Methods Forty-eight patients suffering from severe craniocerebral injury combined with cerebral infarction were randomized into the treatment group (managed by large craniotomy decompression) and the control group (managed by clearance of hematoma by routine craniotomy ).A retrospective analysis was carried out to compare the cerebral infarction size between the two groups before operation and at day 1 and 1 week after operation and the outcomes of the two corresponding groups three months post-operatively.Results The infarction size of the treatment group was insignificant in comparison with that of the control group pre-operatively and at day 1 post-operatively,but was significantly smaller than that of the control group one week post-operatively (P ＜ 0.05 ).The mortality and moderate disability/good rate of the treatment and control groups presented significant differences three months post-operatively (21％,42％ vs 33％,25％ respectively,P ＜ 0.05 ).Conclusion Large craniotomy decompression is effective in treating severe craniocerebral injury combined with cerebral infarction and plays an important role in reducing disability and mortality.