探讨开颅去骨瓣减压术后并发硬膜下积液危险因素及治疗方法。

回顾性分析武警河北总队医院神经外科自2014年12月至2016年12月收治的31例去骨瓣减压术后并发硬膜下积液患者的临床资料，发生硬膜下积液患者行弹力绷带加压包扎及腰穿放液治疗，难愈者在颅骨修补时假性硬脑膜切小口放出积液，再缝合后用塑性钛网修补。

去骨瓣减压同侧硬膜下积液28例，均给予弹力绷带加压包扎，其中2例在颅骨修补时放出积液后塑性钛网修补；3例对侧硬膜下积液和大脑廉旁硬膜下积液给予腰穿+弹力绷带加压包扎。所有患者术后随访3个月~1年，复查头颅CT未见硬膜下积液复发。

对于去骨瓣减压术后并发硬膜下积液患者治疗早期应用弹力绷带包扎骨窗，有利于维持颅腔的压力平衡，防止脑组织过度膨出，有利于硬膜下积液的减少产生和吸收，改善预后。

To investigate the risk factors and treatment of subdural effusion after decompressive craniectomy.

From December 2014 to December 2016 in the Department of Nerurosurgery of the General Hospital of Chinese People’s Armed Police Forces, a total of 31 patients with subdural effusion after decompressive craniectomy were selected, and their clinical data were retrospectively analyzed, the cases with subdural effusion were treated by elastic bandage and lumbar puncture drainage, the patients who were difficult to cure were cut a small dural to release subdural effusion, then made up with shaping titanium mesh after suture.

Of the 28 cases with ipsilateral subdural effusion treated by decompressive craniectomy received elastic bandage pressure bandage, plastic titanium mesh repair was performed in 2 cases with effusion after skull repair, 3 patients with contralateral subdural effusion and falx subdural effusion lumbar puncture and elastic bandage. Followe-up lasted 3 months to 1 year in all the cases, no subdural effusion recurrence was observed reexamination of skull CT.

Application of elastic bandage dressing bone window for patients with subdural effusion after decompressive craniectomy is conducive to maintain the pressure balance of the cranium and the reduction and generation of subdural effusion, and prevent excessive swelling of brain tissue to improve prognosis.