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中华神经创伤外科电子杂志

中华神经创伤外科电子杂志 ›› 2020, Vol. 06 ›› Issue (02) : 110 -112. doi: 10.3877/cma.j.issn.2095-9141.2020.02.010

所属专题： 文献；

短篇论著

双额去骨瓣减压术治疗双侧额叶挫裂伤致中央型脑疝的临床报告
吕学明1, 赵振宇1,†(), 初晨宇1, 孙新同1, 卢培刚1, 袁绍纪1   
  1. 1. 250031　济南，解放军第九六〇医院神经外科
  • 收稿日期:2019-08-17 出版日期:2020-04-15
  • 通信作者: 赵振宇
  • 基金资助:
    国家自然科学基金(81400919)

Effect of bilateral decompressive craniectomy in the treatment of double frontal brain contusion complicated with central brain herniation

Xueming Lyu1, Zhenyu Zhao1,†(), Chenyu Chu1, Xintong Sun1, Peigang Lu1, Shaoji Yuan1   

  1. 1. Department of Neurosurgery, 960 Hospital of PLA, Ji’nan 250031, China
  • Received:2019-08-17 Published:2020-04-15
  • Corresponding author: Zhenyu Zhao
  • About author:
    Corresponding author: Zhao Zhenyu, Email:
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吕学明, 赵振宇, 初晨宇, 孙新同, 卢培刚, 袁绍纪. 双额去骨瓣减压术治疗双侧额叶挫裂伤致中央型脑疝的临床报告[J]. 中华神经创伤外科电子杂志, 2020, 06(02): 110-112.

Xueming Lyu, Zhenyu Zhao, Chenyu Chu, Xintong Sun, Peigang Lu, Shaoji Yuan. Effect of bilateral decompressive craniectomy in the treatment of double frontal brain contusion complicated with central brain herniation[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2020, 06(02): 110-112.

目的

探讨针对双侧额叶挫裂伤致中央型脑疝采用双额去骨瓣减压术的疗效。

方法

选择解放军第九六〇医院神经外科自2010年7月至2016年12月收治的65例采用双额去骨瓣减压术治疗双侧额叶挫裂伤致中央型脑疝患者为研究对象，评估手术效果及预后。

结果

65例患者术后随访6个月至1年，采用GOS评分评估预后：预后良好（4~5分）20例；预后不良：2分13例，3分17例；死亡（1分）15例。其中GOS评分2~3分的30例患者术后长期随访(至少3年)显示，其GOS评分改善不明显。

结论

双侧额叶挫裂伤病情发展快，易导致中央型脑疝发生，双额去骨瓣减压术是治疗中央型脑疝患者的有效手段。

关键词: 双额去骨瓣减压术, 挫裂伤, 中央型脑疝
Objective

To investigate the effect of bilateral frontal decompressive craniectomy in the treatment of central herniation caused by bilateral frontal lobe contusion and laceration.

Methods

From July 2010 to December 2016, 65 patients with central herniation caused by bilateral frontal lobe contusion and laceration were treated with bilateral frontal decompression. The operative effect and prognosis were evaluated.

Results

The GOS prognostic score from 6 months to 1 year after operation was 4-5 in 20 cases, 3 in 17 cases, 2 in 13 cases and 1 in 15 cases, with a total of 30 cases having poor prognosis. Long-term follow-up (at least 3 years) of 30 patients with GOS score of 2-3 showed that GOS had little improvement in 3 years after operation.

Conclusion

Bilateral frontal lobe contusion and laceration develops rapidly, which can easily lead to central herniation. Decompression of bilateral frontal bone flap is an effective method for the treatment of central herniation.

Key words: Bilateral frontal lobe contusion, Central herniation, Bilateral decompressive craniectomy
图2 双侧额叶挫裂伤患者行大冠状双额去骨瓣减压术前、术后及随访的头颅CT影像
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