冠状切口双额部去骨瓣减压术抢救重型颅脑损伤患者的临床效果.docVIP

冠状切口双额部去骨瓣减压术抢救重型颅脑损伤患者的临床效果 　　【摘要】 目的：探讨冠状切口双侧额部去骨瓣减压，必要时同时行额叶切除内减压术的手术方式抢救双侧额、颞叶广泛挫伤的重型颅脑损伤患者的治疗效果。方法：取额部发际内冠状切口，行双侧额部去骨瓣减压，根据患者情况必要时行额叶切除内减压术。结果：本组40例患者中恢复良好12例，中残14例，重残6例，植物生存1例，死亡7例。结论：冠状切口双侧额部去骨瓣减压术能提高双侧额叶、颞叶广泛挫伤的重型颅脑损伤患者的抢救治疗效果，值得在临床中尝试、推广。 　　【关键词】 双侧额部去骨瓣减压术； 冠状切口； 重型颅脑损伤 　　中图分类号 R651.1 文献标识码 B 文章编号 1674-6805（2014）3-0127-02 　　Clinical Effect of Coronary Incision Bilateral Frontal Decompressive Craniectomy in the Rescue of Patients with Severe Craniocerebral Injury/YANG Li-hang，GAN Chao-min，CUN Shou-kui，et al.//Chinese and Foreign Medical Research，2014，12（3）：127-128 　　【Abstract】 Objective：To investigate the therapeutic effect of the operation method of the coronary incision bifrontal frontal decompressive craniotomy（at the same time the frontal lobe resection decompression should be carried out if it is necessary）in the rescue of severe craniocerebral injury patients with extensive contusion in bilateral frontal and temporal lobe.Method：The forehead hairline coronal incisions were chosen， and bilateral frontal craniotomy were given， and according to the situation of patients the frontal lobe excision decompression would be used if it was necessary.Result：In 40 cases the recovery situations of 12 cases were good， and 14 cases were moderate disability， and 6 cases were severe disability， and 1 case was plant survival， and 7 patients dead.Conclusion：The coronary incision bifrontal frontal decompressive craniotomy can improve the treatment effect in severe craniocerebral injury patients with extensive contusions of bilateral frontal and temporal lobe， and it is worthy of trying and promotion in the clinical. 　　【Key words】 Bifrontal frontal decompressive craniotomy； Coronary incision； Severe craniocerebral injury 　　First-author’s address：The People’s Hospital of Tengchong County，Tengchong 679100，China 　　笔者所在科室2009年4月-2013年4月采用冠状切口双侧额部去骨瓣减压，必要时同时行额叶切除内减压术的手术方式抢救以双侧额、颞叶广泛挫伤为主的重型颅脑损伤患者40例，治疗效果满意，现报告如下。 　　1 资料与方法 　　1.1 一般资料 　　本组40例患者，男32例，女8例；年龄16～79岁，平