去骨瓣减压术治疗创伤性脑损伤的技术要点。
Technical considerations in decompressive craniectomy in the treatment of traumatic brain injury.
机构信息
Department of Neurosurgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
出版信息
Int J Med Sci. 2010 Nov 8;7(6):385-90. doi: 10.7150/ijms.7.385.
Refractory intracranial hypertension is a leading cause of poor neurological outcomes in patients with severe traumatic brain injury. Decompressive craniectomy has been used in the management of refractory intracranial hypertension for about a century, and is presently one of the most important methods for its control. However, there is still a lack of conclusive evidence for its efficacy in terms of patient outcome. In this article, we focus on the technical aspects of decompressive craniectomy and review different methods for this procedure. Moreover, we review technical improvements in large decompressive craniectomy, which is currently recommended by most authors and is aimed at increasing the decompressive effect, avoiding surgical complications, and facilitating subsequent management. At present, in the absence of prospective randomized controlled trials to prove the role of decompressive craniectomy in the treatment of traumatic brain injury, these technical improvements are valuable.
难治性颅内高压是严重创伤性脑损伤患者神经功能预后不良的主要原因。去骨瓣减压术已用于难治性颅内高压的治疗近一个世纪，目前是其控制的最重要方法之一。然而，在患者预后方面，其疗效仍缺乏确凿的证据。在本文中，我们重点关注去骨瓣减压术的技术方面，并回顾该手术的不同方法。此外，我们还回顾了目前大多数作者推荐的大骨瓣减压术的技术改进，旨在增加减压效果、避免手术并发症，并便于后续管理。目前，由于缺乏前瞻性随机对照试验来证明去骨瓣减压术在创伤性脑损伤治疗中的作用，这些技术改进是有价值的。
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