Obeservation of treatment effects on severe craniocerebral trauma by controlled stepped intracranial decompression surgery

doi:10.3877/cma.j.issn.2095-9141.2015.03.007

Abstract

Abstract:

Objective

To investigate the effects of controlled ladder type decompression and standard large craniotomy for treatment of severe craniocerebral injury.

Methds

Among 80 severe craniocerebral injury cases，40 (A group) underwent controlled ladder type decompression and 40 (B group)underwent decompression of routine standard large eraniotomy.

Results

The incidences of acute intraoperative encephalocele，delayed intracranial hematoma，cerebral infarction and GOS score of two groups were significantly different (P＜0.05).

Conclusion

The controlled decompression could decrease intraoperative complications，disability rate and mortality of severe craniocerebral injury patients.

Key words: Craniocerebral trauma, Neurosurgical procedures, Encephalocele, Delayed hematoma

Tao Liu, Huanqing Fa. Obeservation of treatment effects on severe craniocerebral trauma by controlled stepped intracranial decompression surgery[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2015, 01(03): 148-151.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhsjcswkdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-9141.2015.03.007

https://zhsjcswkdzzz.cma-cmc.com.cn/EN/Y2015/V01/I03/148

Figures/Tables 3

References 16

[1]	林超,董艳,于明琨,等.创伤性颅脑损伤去骨瓣减压术后并发症的危险因素分析[J]. 第二军医大学学报, 2012, 33(11):1260-1262.
[2]	Kolias AG, Guilfoyle MR, Helmy A, et a1.Traumatic brain injury in aduhs[J].Pract Neurol,2013,13(4):228-235.
[3]	张学慧,秦振字,涂博.标准外伤大骨瓣减压术治疗特重型颅脑损伤临床分析[J].临床医学杂志,2013,23(8):31-33.
[4]	Adigun TA, Adeolu AA. Factors influencing the immediate postoperative outcome in operated head in injured patients in lbadan Nigeria[J].Afr J Med Med Sci,2012,41(3):301-305.
[5]	Guerra WKW, Gaab MR, Dietz H, et al. Surgical decompression for traumatic brain swelling: indications and results[J].J Neurosurg,1999,90(1):187-196.
[6]	孙文栋,刘振杰.标准大骨瓣减压术和控制性减压术防治老年重型颅脑损伤并发脑梗死的疗效[J]. 中国老年学杂志,2013,33(19):4731-4733.
[7]	王正锐,李平,高永清,等.逐步控制性减压手术治疗重型、特重型颅脑损伤[J].中华神经外科杂志,2011,27(11):1155.
[8]	张海波, 孙阳. 重型颅脑损伤并发脑梗死76 例临床分析[J].中国社区医师,2013,15(10):67.
[9]	Skoglund TS, Eriksson-Ritzen C, Jensen C, et a1. Aspects on decompressive craniectomy in patients with traumatic head injuries[J].J Neurotrauma,2006,23(2):1502-1509.
[10]	王玉海,杨理坤,蔡学见,等.控制性减压治疗重型、特重型颅脑损伤[J].中华神经外科杂志,2010,26(5):819-822.
[11]	刘红卫,贺世明.急性重型硬膜下血肿快速救治新方法[J].基层医学论坛,2012,16(7):829-830.
[12]	杨杰,肖锋,袁小兵,等.动态超声观察在术中急性脑膨出围手术期的应用研究[J]. 中华神经医学杂志, 2010, 9(2):196-197.
[13]	Huang YH, Lee TC, Lee TH, et al. Remote epidural hemorrhage after unilateral decompressive hemieranieetomy in brain-injured patients[J].J Neurotrauma,2013,30(2):96-101.
[14]	Mitchell P, Tseng M, Mendelow AD. Decompressive craniectomy with lattice duraplasty[J]. Acta Neurochir(Wien),2004,146(2):159-160.
[15]	李王安,荆国杰,姚晓腾,等.急重型硬膜下血肿术中应用快速硬膜网状切开[J].中华神经医学杂志,2014,13(4):407-408.
[16]	胡连水,张明升,王文浩,等.锥、钻颅引流减压抢救急性硬膜外(下)血肿致脑疝患者的临床研究[J]. 中华神经医学杂志,2012,11(9):908-911.

组别	性别(例)男/女	年龄(岁)	单侧/双侧瞳孔散大(例)	术前GCS评分
A组	27/13	41.8±11.81	27/13	6.25±2.61
B组	28/12	39.11±12.75	29/11	5.30±2.44
t或χ²值	0.058	-0.992	0.238	-1.696
P值	0.809	0.324	0.626	0.094

组别	性别(例)男/女	年龄(岁)	单侧/双侧瞳孔散大(例)	术前GCS评分
A组	27/13	41.8±11.81	27/13	6.25±2.61
B组	28/12	39.11±12.75	29/11	5.30±2.44
t或χ²值	0.058	-0.992	0.238	-1.696
P值	0.809	0.324	0.626	0.094

组别	例数	急性脑膨出	迟发性血肿	术后脑梗塞
A组	40	3(7.5%)	7(17.5%)	2(5.0%)
B组	40	11(27.5%)	15(37.5%)	10(25.0%)
χ²		5.541	4.013	-0.280
P值		0.019	0.045	0.012

组别	例数	急性脑膨出	迟发性血肿	术后脑梗塞
A组	40	3(7.5%)	7(17.5%)	2(5.0%)
B组	40	11(27.5%)	15(37.5%)	10(25.0%)
χ²		5.541	4.013	-0.280
P值		0.019	0.045	0.012

组别	例数	良好	中残	重残	植物状态	死亡	秩和	Z值	P值
A组	40	24(60.0)	4(10.0)	3(7.5)	2(5.0)	7(17.5)	1339.00	-2.891	0.004
B组	40	13(32.5)	1(2.5)	2(5.0)	8(20.0)	16(40.0)	1901.00	-2.891	0.004

Please choose a citation manager

Content to export