Fourcade O, Fuzier R, Daboussi A, Gigaud M, Trémoulet M, Samii K
Département d'Anesthésie-Réanimation, Hôpital Purpan, CHU de Toulouse, Université Paul-Sabatier, place du Docteur-Baylac, 31059 Toulouse cedex 09, France.
Ann Fr Anesth Reanim. 2006 Aug;25(8):858-62. doi: 10.1016/j.annfar.2006.03.015. Epub 2006 May 3.
Decompressive craniectomy was purposed for the treatment of refractory intracranial hypertension after head injury. This review discusses results obtained by this surgery in severe head trauma. Several studies have confirmed a reduction in intracranial pressure secondary to decompressive craniectomy. Mortality decreased and the proportion of good outcome of the survivors increased. These results have not been confirmed prospectively, and indications have to be clarified. The positive effects of decompressive craniectomy compared to barbiturate or hypocapnia in the "second tier therapy" in refractory intracranial hypertension could be interesting to evaluate.
去骨瓣减压术旨在治疗颅脑损伤后难治性颅内高压。本综述讨论了该手术在重型颅脑创伤中的治疗结果。多项研究证实，去骨瓣减压术可降低颅内压。死亡率降低，幸存者良好预后的比例增加。这些结果尚未得到前瞻性证实，手术指征有待明确。在难治性颅内高压的“二线治疗”中，评估去骨瓣减压术与巴比妥类药物或低碳酸血症相比的积极效果可能会很有意义。
