中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2014年
6期
495-499
,共5页
邵雪非%武银刚%沈军%王宣之%方新运%黄华%陶进%徐善水%许安定
邵雪非%武銀剛%瀋軍%王宣之%方新運%黃華%陶進%徐善水%許安定
소설비%무은강%침군%왕선지%방신운%황화%도진%서선수%허안정
颅脑损伤%脑水肿%减压术,外科%颅腔代偿容积
顱腦損傷%腦水腫%減壓術,外科%顱腔代償容積
로뇌손상%뇌수종%감압술,외과%로강대상용적
Craniocerebral trauma%Brain edema%Decompression,surgical%Cranial compensatory volume
目的 探讨改良大骨瓣开颅减压术(modified decompression craniotomy,MDC)治疗创伤后急性弥漫性脑肿胀(post-traumatic acute diffuse brain swelling,PADBS)的作用. 方法 回顾性分析48例临床资料,31例采取标准大骨瓣开颅减压术(standard large trauma decompression craniotomy,SDC),17例采取MDC.分析两组临床资料、颅腔代偿容积、术后并发症发生率及6个月后格拉斯哥预后评分(Glasgow outcome scale,GOS). 结果 MDC所获得的颅腔容积代偿增加值约占颅腔容积的8.2%.两组术后并发症包括再出血、颅内感染、切口疝、癫痫、切口脑脊液漏和脑积水,组间比较差异均无统计学意义(P>0.05).术后6个月GOS评分:预后良好(4~5分)SDC组为13例(42%),MDC组为13例(76%);预后不良(2~3分)SDC组为13例(42%),MDC组为3例(18%);SDC组死亡5例(16%),MDC组死亡1例(6%).MDC组预后优于SDC组(Z=2.318,P<0.05). 结论 对PADBS患者采用MDC,可提高患者治疗效果,改善预后.
目的 探討改良大骨瓣開顱減壓術(modified decompression craniotomy,MDC)治療創傷後急性瀰漫性腦腫脹(post-traumatic acute diffuse brain swelling,PADBS)的作用. 方法 迴顧性分析48例臨床資料,31例採取標準大骨瓣開顱減壓術(standard large trauma decompression craniotomy,SDC),17例採取MDC.分析兩組臨床資料、顱腔代償容積、術後併髮癥髮生率及6箇月後格拉斯哥預後評分(Glasgow outcome scale,GOS). 結果 MDC所穫得的顱腔容積代償增加值約佔顱腔容積的8.2%.兩組術後併髮癥包括再齣血、顱內感染、切口疝、癲癇、切口腦脊液漏和腦積水,組間比較差異均無統計學意義(P>0.05).術後6箇月GOS評分:預後良好(4~5分)SDC組為13例(42%),MDC組為13例(76%);預後不良(2~3分)SDC組為13例(42%),MDC組為3例(18%);SDC組死亡5例(16%),MDC組死亡1例(6%).MDC組預後優于SDC組(Z=2.318,P<0.05). 結論 對PADBS患者採用MDC,可提高患者治療效果,改善預後.
목적 탐토개량대골판개로감압술(modified decompression craniotomy,MDC)치료창상후급성미만성뇌종창(post-traumatic acute diffuse brain swelling,PADBS)적작용. 방법 회고성분석48례림상자료,31례채취표준대골판개로감압술(standard large trauma decompression craniotomy,SDC),17례채취MDC.분석량조림상자료、로강대상용적、술후병발증발생솔급6개월후격랍사가예후평분(Glasgow outcome scale,GOS). 결과 MDC소획득적로강용적대상증가치약점로강용적적8.2%.량조술후병발증포괄재출혈、로내감염、절구산、전간、절구뇌척액루화뇌적수,조간비교차이균무통계학의의(P>0.05).술후6개월GOS평분:예후량호(4~5분)SDC조위13례(42%),MDC조위13례(76%);예후불량(2~3분)SDC조위13례(42%),MDC조위3례(18%);SDC조사망5례(16%),MDC조사망1례(6%).MDC조예후우우SDC조(Z=2.318,P<0.05). 결론 대PADBS환자채용MDC,가제고환자치료효과,개선예후.
Objective To investigate the effect of modified decompression craniotomy (MDC) for treatment of extremely severe post-traumatic acute diffuse brain swelling (PADBS).Methods Forty-eight patients with PADBS out of which 31 underwent standard large trauma decompression craniotomy (SDC) and 17 MDC were analyzed retrospectively.Clinical data,cranial capacity compensation,postoperative complications,and Glasgow outcome scale (GOS) 6 months after operation were recorded and compared between the two groups.Results Increased cranial capacity compensatory value accounted for 8.2% of the cranial capacity after MDC.Postoperative complications included rehemorrhage,intracranial infection,incisional hernia,epilepsy,cerebrospinal fluid leakage,and hydrocephalus and no statistical differences were observed between the two groups (P > 0.05).Based on GOS,the outcome was good in 13 patients (42%),poor in 13 (42%),with 5 deaths (16%) in SDC group,while the outcome was good in 13 patients (76%),poor in 3 (18%),with 1 death (6%) in MDC group.The outcome in MDC group was better than that in SDC group (Z =2.318,P < 0.05).Conclusion For patients with PADBS,MDC can improve the outcome and prognosis.