CAJ | 학술논문

目的探讨标准大骨瓣减压加坏死脑组织清除治疗外伤后恶性脑肿胀的疗效.方法 80例伴发外伤后恶性脑肿胀的重型颅脑损伤患者,40例行标准大骨瓣开颅减压手术治疗,40例行标准大骨瓣开颅减压加坏死脑组织清除手术治疗,术后15 d及术后6个月观察治疗效果,对结果进行比较分析.结果标准大骨瓣减压加坏死脑组织清除手术治疗组患者术后15 d内颅高压发生率37.5%(15/40)、脑组织切口疝发生率32.5%(13/40),均明显低于单纯标准大骨瓣减压手术治疗组,分别为15.0%(6/40)和10.0%(4/40),P<0.05,伤后6个月患者优良(良好+中残)率(60.0%)显著高于单纯标准大骨瓣减压手术治疗组(40.0%),P<0.05.结论采用标准大骨瓣减压加坏死脑组织清除手术可有效降低外伤后恶性脑肿胀患者的颅高压,降低重型颅脑损伤患者病死率和致残率,提高治疗效果.
목적 탐토표준대골판감압가배사뇌조직청제치료외상후악성뇌종창적료효.방법 80례반발외상후악성뇌종창적중형로뇌손상환자,40례행표준대골판개로감압수술치료,40례행표준대골판개로감압가배사뇌조직청제수술치료,술후15 d급술후6개월관찰치료효과,대결과 진행비교분석.결과 표준대골판감압가배사뇌조직청제수술치료조환자술후15 d내로고압발생솔37.5%(15/40)、뇌조직절구산발생솔32.5%(13/40),균명현저우단순표준대골판감압수술치료조,분별위15.0%(6/40)화10.0%(4/40),P<0.05,상후6개월환자우량(량호+중잔)솔(60.0%)현저고우단순표준대골판감압수술치료조(40.0%),P<0.05.결론 채용표준대골판감압가배사뇌조직청제수술가유효강저외상후악성뇌종창환자적로고압,강저중형로뇌손상환자병사솔화치잔솔,제고치료효과.
Objective To observe the curative effects of malignant brain swelling after brain injury by using the operations of standard large Craniotomy decompression and removal of necrotic brain tissues. Methods 80 cases of malignant brain swelling after severe brain injury were observed. The standard decompression surgery of large era-niotomy routine were used in 40 cases,while the operations of standard large craniotomy decompression and removal of necrotic brain tissues were used in the other 40 cases. The curative effects of the results after 15 days and six mon-ths were analyzed. Results The incidence of intracranial hypertension (37.5%, 15/40 ) and brain tissue incisional hernia (32.5% ,13/40)of the group using standard large craniotomy decompression and removal of nee-rotic brain tissues treatment was significantly lower than that of simple standard large craniotomy decompression treat-ment group [15.0% (6/40) vs 10.0% (4/40)] after 15 days (P<0.05 ). The prognosis excellent rate ( good + re-sidual) of the group using standard large Craniotomy decompression and removal of necrotic brain tissues treatment was significantly higher (60.0%) than that of simple standard large craniotomy decompression treatment group (40.0%) after six months (P<0.05 ). Conclusion The operations of standard large craniotomy decompression and removal of necrotic brain tissues can effectively reduce the intracranial hypertension of malignant brain swelling after trauma injury,and reduce mortality and morbidity of severe brain injury.