CAJ | 학술논문

目的：探讨半球骨瓣减压结合控制性减压治疗特重型颅脑损伤的临床疗效。方法采用去半球大骨瓣彻底减压技术，结合硬脑膜网状切开和有限渐次减压法等控制性减压，对60例特重型颅脑损伤患者进行手术治疗，术后6个月进行GOS评分评价，3～4分为良好，2分为中度残废，1分为重度残废。结果死亡25例（病死率为41．7％），存活35例，其中恢复良好10例，中度残废1例，重度残废14例。结论去半球骨瓣伴控制性减压技术具有显露好、减压充分等优点，可有效降低手术病死率。
목적：탐토반구골판감압결합공제성감압치료특중형로뇌손상적림상료효。방법채용거반구대골판철저감압기술，결합경뇌막망상절개화유한점차감압법등공제성감압，대60례특중형로뇌손상환자진행수술치료，술후6개월진행GOS평분평개，3～4분위량호，2분위중도잔폐，1분위중도잔폐。결과사망25례（병사솔위41．7％），존활35례，기중회복량호10례，중도잔폐1례，중도잔폐14례。결론거반구골판반공제성감압기술구유현로호、감압충분등우점，가유효강저수술병사솔。
Objective To investigate the clinical efficacy of hemi-spheric craniotomy combined with controlled decompression in treating extra severe-craniocerebral injuries.Methods Sixty patients with extra-severe craniocerebral injuries were operated by hemi-spheric craniotomy,and the controlled decompression of dural netted incision and limited decompression was gradually performed in the patients.The patients were followed up for 6 months,in which 3 to 4 scores were good prognosis and 2 scores were moderate disability and 1 score was se-vere disability according to GOS scores.Results Twenty-five cases died(the mortality rate was 41.7%),35 cases survived,among whom 10 cases had good prognosis,1case moderate disability and 14 cases severe disability.Conclusion The hemi-spheric craniotomy combined with controlled decompression can decrease the mortality rate by good exposure and adequate decompression.