Honeybul S, Ho K M
Department of Neurosurgery, Sir Charles Gairdner Hospital and Royal Perth Hospital, Western Australia, Australia.
Department of Intensive Care Medicine, Royal Perth Hospital and School of Population Health, University of Western Australia, Australia.
Aust Crit Care. 2014 May;27(2):85-91. doi: 10.1016/j.aucc.2013.06.001. Epub 2013 Jul 11.
There continues to be considerable amount of interest in decompressive craniectomy however its use is controversial. It is technically straightforward however it is not without significant complications and although there is currently unequivocal evidence available that it can be a life saving intervention, evidence that outcome is improved over and above standard medical therapy is less forthcoming. This narrative review considers the current role of decompressive craniectomy in the management of neurological emergencies and focuses on four specific questions, namely; (i) Is the decompressive craniectomy a life saving procedure? (ii) Does decompressive craniectomy improve outcome? (iii) Are there any risks associated with decompressive craniectomy? (iv) How do patients feel about their eventual outcome? Finally the future directions for the use of decompressive craniectomy are explored.
尽管减压性颅骨切除术的使用存在争议，但人们对它的兴趣依然浓厚。该手术在技术上操作简单，但并非没有严重并发症。虽然目前有明确证据表明它是一种可以挽救生命的干预措施，但关于其效果优于标准药物治疗的证据却较少。这篇叙述性综述探讨了减压性颅骨切除术在神经急症管理中的当前作用，并聚焦于四个具体问题，即：（i）减压性颅骨切除术是一种挽救生命的手术吗？（ii）减压性颅骨切除术能改善预后吗？（iii）减压性颅骨切除术有哪些风险？（iv）患者对其最终预后的感受如何？最后，还探讨了减压性颅骨切除术的未来应用方向。
