临床神经外科杂志
臨床神經外科雜誌
림상신경외과잡지
Journal of Clinical Neurosurgery
2015年
5期
372-374
,共3页
王忠%贾文彬%苏宁%张晓军%戚建军%赵卫平%张义松%张仲
王忠%賈文彬%囌寧%張曉軍%慼建軍%趙衛平%張義鬆%張仲
왕충%가문빈%소저%장효군%척건군%조위평%장의송%장중
冠状切口%双额大骨瓣减压术%额颞叶脑挫裂伤%早期颅骨修补
冠狀切口%雙額大骨瓣減壓術%額顳葉腦挫裂傷%早期顱骨脩補
관상절구%쌍액대골판감압술%액섭협뇌좌렬상%조기로골수보
coronal incision%bifrontal decompressive craniectomy%contusion and laceration of bilateral frontal and temporal lobes%early cranioplasty
目的:探讨应用冠切双额大骨瓣减压术对重型双侧额颞叶脑挫裂伤及早期颅骨修补的效果。方法回顾性分析冠切双额大骨瓣开颅手术治疗的56例重型双侧额颞叶脑挫裂伤伴难治性高颅内压患者的临床资料。术后随访6个月,以格拉斯哥预后量表( COS)评分判定患者的疗效。结果本组患者恢复良好33例,轻残12例,重残5例,植物生存3例,死亡3例。恢复良好的患者中早期行自体或塑形钛网颅骨修补术28例。结论双额冠状切口大骨瓣减压术能有效解除或减轻双额颞叶脑挫裂伤患者的颅内高压,在重型双侧额颞叶脑挫裂伤的抢救中是一种有效的方法,能明显提高抢救成功率,降低致残率和病死率,改善患者的预后。
目的:探討應用冠切雙額大骨瓣減壓術對重型雙側額顳葉腦挫裂傷及早期顱骨脩補的效果。方法迴顧性分析冠切雙額大骨瓣開顱手術治療的56例重型雙側額顳葉腦挫裂傷伴難治性高顱內壓患者的臨床資料。術後隨訪6箇月,以格拉斯哥預後量錶( COS)評分判定患者的療效。結果本組患者恢複良好33例,輕殘12例,重殘5例,植物生存3例,死亡3例。恢複良好的患者中早期行自體或塑形鈦網顱骨脩補術28例。結論雙額冠狀切口大骨瓣減壓術能有效解除或減輕雙額顳葉腦挫裂傷患者的顱內高壓,在重型雙側額顳葉腦挫裂傷的搶救中是一種有效的方法,能明顯提高搶救成功率,降低緻殘率和病死率,改善患者的預後。
목적:탐토응용관절쌍액대골판감압술대중형쌍측액섭협뇌좌렬상급조기로골수보적효과。방법회고성분석관절쌍액대골판개로수술치료적56례중형쌍측액섭협뇌좌렬상반난치성고로내압환자적림상자료。술후수방6개월,이격랍사가예후량표( COS)평분판정환자적료효。결과본조환자회복량호33례,경잔12례,중잔5례,식물생존3례,사망3례。회복량호적환자중조기행자체혹소형태망로골수보술28례。결론쌍액관상절구대골판감압술능유효해제혹감경쌍액섭협뇌좌렬상환자적로내고압,재중형쌍측액섭협뇌좌렬상적창구중시일충유효적방법,능명현제고창구성공솔,강저치잔솔화병사솔,개선환자적예후。
Objective To explore the efficacy of bifrontal decompressive craniectomy via bilateral frontal coronal incision in treating severe contusion and laceration of bilateral frontal and temporal lobes and early cranioplasty .Methods The clinical data of 46 patients with contusion and laceration of bilateral frontal and temporal lobes who were treated with bilateral decompressive craniectomy were analyzed retrospectively .The prognosis were evaluated at 6 months after surgery by Glasgow outcome scale (GOS) score.Results There were 33 cases who got good recovery ,12 cases with moderate deficit , other 5 cases got severe deficit ,3 cases with persistent vegetative status and 3 cases death .20 cases who got good recovery were treated early cranioplasty with in vitro bone flap or computer-assisted design titanium mesh after bifrontal decompressive craniectomy 1-3 month. Conclusions bifrontal decompressive craniectomy with bilateral frontal coronal incision in treating severe contusion and laceration of bilateral frontal and temporal lobes can significantly relieve severe intracranial hypertension of patients with contusion and laceration of bilateral frontal and temporal lobes.And it can improve the prognosis obviously and increase the rate of successful rescue and decrease the rate of mortality and disability .