Zhang Yun-Dong, Zhou Ji, Li Bing, Zhang Yi-Hua, Yang Hua-Jiang, Wang Hao, Gu Xiao-Hong
Department of Neurosurgery, Daping Hospital Affiliated to the Third Military Medical University, Chongqing 400042, China.
Chin J Traumatol. 2012;15(4):228-30.
To elucidate the therapeutic effect of subtemporal decompressive craniotomy with large flap resection on serious craniocerebral injury associated with cerebral infarction.
Forty-eight cases of serious head injury accompanied by cerebral infarction were classified into two groups with each having 24 cases: treatment group, in which large bone-flap decompressive craniotomy was performed; control group, in which routine craniotomy and hematoma evacuation were adopted. The status of cerebral infarction pre- and post-operation, as well as the curative effect 3 months after operation were comparatively analysed between the two groups.
There was no significant difference regarding the status of cerebral infarction on the first day after operation; while one week after operation, the size of cerebral infarction was significantly smaller in treatment group than control one (P less than 0.05). Postoperative 3 months, the mortality rate was 20.8% in treatment group, being evidently superior to that of control group (33.3%, P less than 0.05). The mo- derate disability (good and fair) rate was 41.7% in treatment group, significantly higher than that in control group (25.0%, P less than 0.05).
Large bone-flap decompressive craniotomy is confirmed effective and hence it offers us a preferable alternative of treatment by which to reduce disability and fatality rates for patients with serious head injury accompanied by cerebral infarction.
探讨颞下减压大骨瓣切除术治疗重型颅脑损伤合并脑梗死的疗效。
将48例重型颅脑损伤合并脑梗死患者分为两组，每组24例。治疗组采用大骨瓣减压开颅术；对照组采用常规开颅血肿清除术。比较两组患者术前、术后脑梗死情况及术后3个月的疗效。
术后第1天两组脑梗死情况差异无统计学意义；术后1周，治疗组脑梗死面积明显小于对照组（P<0.05）。术后3个月，治疗组死亡率为20.8%，明显优于对照组（33.3%，P<0.05）。治疗组中重度残疾（良好和中等）率为41.7%，明显高于对照组（25.0%，P<0.05）。
大骨瓣减压开颅术被证实有效，为降低重型颅脑损伤合并脑梗死患者的致残率和死亡率提供了一种较好的治疗选择。
