CAJ | 학술논문

目的：探讨额颞叶脑挫裂伤/迟发脑内血肿引起脑疝的特点，提高手术救治水平。方法：采用保留额部骨瓣的额颞顶部开颅颞肌下减压术，在脑疝代偿期进行手术治疗。结果：额颞叶脑挫裂伤/迟发脑内血肿并脑疝患者手术治疗37例，运用GOS判断预后，代偿期手术34例Ⅴ级，失代偿期手术3例Ⅳ(情感、精神活动障碍)。结论：额颞顶部开颅利于脑挫裂伤灶彻底清创、保护有活力的额叶脑组织。颞肌下减压比额部骨瓣减压能更好的缓解颅内深部压力；保留额部骨瓣，更好的保护了额叶脑组织及其功能，防止术后严重并发征及容貌丑形。
목적：탐토액섭협뇌좌렬상/지발뇌내혈종인기뇌산적특점，제고수술구치수평。방법：채용보류액부골판적액섭정부개로섭기하감압술，재뇌산대상기진행수술치료。결과：액섭협뇌좌렬상/지발뇌내혈종병뇌산환자수술치료37례，운용GOS판단예후，대상기수술34례Ⅴ급，실대상기수술3례Ⅳ(정감、정신활동장애)。결론：액섭정부개로리우뇌좌렬상조철저청창、보호유활력적액협뇌조직。섭기하감압비액부골판감압능경호적완해로내심부압력；보류액부골판，경호적보호료액협뇌조직급기공능，방지술후엄중병발정급용모축형。
Objective:To investigate the characteristic of cerebral herniation caused by fronto-temporal brain contusion and delayed intracerebral hematoma and improve surgical treatment level.Methods:Fronto-temporo-parietal craniotomy reserving forehead bone flap and sub-emporalis-decompression was employed before the brain herniation was decompensated.Results:37 patiants suffered fronto-temporal brain contusion and delayed intracerebral hematoma were operated.The prognosis was favorable in 34 patiants with GOS score of 5 and 3 patiants with GOS score of 3(with emotional and mental disorder).Conclusion:Fronto-temporo-parietal craniotomy is conductive to completely debride the necrotic brain and protect the viable brain of frontal lobe.Pressure of deep region was more relieved in sub-emporalis-decompression compared with frontal bone flap decompression.Reserving forehead flap is better to protect the frontal lobe brain and their functions,prevent severe postoperative complications and to avoid ugly appearance.