去骨瓣减压术在严重创伤性脑损伤中是否无用？
Is decompressive craniectomy useless in severe traumatic brain injury?
机构信息
Department of Neurosurgery, West China Hospital, Sichuan University, 37 Guoxuexiang Street, Chengdu 610041, The People's Republic of China.
出版信息
Crit Care. 2011;15(5):193. doi: 10.1186/cc10358. Epub 2011 Oct 4.
Abstract
Recently, a multicenter randomized controlled trial (RCT) by Cooper and colleagues indicated that decompressive craniectomy (DC) may be associated with a worse functional outcome in patients with diffuse traumatic brain injury (TBI), although DC can immediately and constantly reduce intracranial pressure (ICP). As this trial is well planned and of high quality, the unexpected result is meaningful. However, the evidence of the study is insufficient and the effect of DC in severe TBI is still uncertain. Additional multicenter RCTs are necessary to provide class I evidence on the role of DC in the treatment of refractory raised ICP after severe TBI.
摘要
最近，库珀（Cooper）及其同事开展的一项多中心随机对照试验（RCT）表明，去骨瓣减压术（DC）可能与弥漫性创伤性脑损伤（TBI）患者的功能结局更差相关，尽管 DC 可立即且持续降低颅内压（ICP）。由于该试验计划周密且质量较高，因此这一意外结果具有意义。然而，该研究的证据尚不充分，DC 在严重 TBI 中的作用仍不确定。需要开展更多的多中心 RCT，以提供关于 DC 在治疗严重 TBI 后难治性 ICP 升高中的作用的 I 类证据。
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Lancet Neurol. 2011 Jun;10(6):497-8. doi: 10.1016/S1474-4422(11)70098-9.
2
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N Engl J Med. 2011 Apr 21;364(16):1493-502. doi: 10.1056/NEJMoa1102077. Epub 2011 Mar 25.
3
Effects of unilateral decompressive craniectomy on patients with unilateral acute post-traumatic brain swelling after severe traumatic brain injury.单侧去骨瓣减压术对重型颅脑损伤后单侧急性外伤性脑肿胀患者的影响。
Crit Care. 2009;13(6):R185. doi: 10.1186/cc8178. Epub 2009 Nov 23.
4
Early decompressive craniectomy for patients with severe traumatic brain injury and refractory intracranial hypertension--a pilot randomized trial.早期减压性颅骨切除术治疗重度创伤性脑损伤合并难治性颅内高压——一项初步随机试验
J Crit Care. 2008 Sep;23(3):387-93. doi: 10.1016/j.jcrc.2007.05.002. Epub 2007 Dec 11.
5
Decompressive craniectomy in traumatic brain injury: the randomized multicenter RESCUEicp study (www.RESCUEicp.com).创伤性脑损伤的减压性颅骨切除术：随机多中心RESCUEicp研究（www.RESCUEicp.com）。
Acta Neurochir Suppl. 2006;96:17-20. doi: 10.1007/3-211-30714-1_4.
6
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J Neurosurg. 2006 Apr;104(4):469-79. doi: 10.3171/jns.2006.104.4.469.
7
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8
Bifrontal decompressive craniectomy in the management of posttraumatic intracranial hypertension.双侧额部减压性颅骨切除术治疗创伤后颅内高压
Br J Neurosurg. 2001 Dec;15(6):500-7. doi: 10.1080/02688690120105110.
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