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脑损伤后减压性颅骨切除术:对患者预后重要的因素。

Decompressive craniectomy following brain injury: factors important to patient outcome.

作者信息

Eghwrudjakpor PatrickO, Allison AkaribariB

机构信息

a Department of Surgery , University of Port Harcourt Teaching Hospital , Port Harcourt Nigeria.

出版信息

Libyan J Med. 2010 Jan;5(1):4620. doi: 10.3402/ljm.v5i0.4620.

DOI:10.3402/ljm.v5i0.4620
PMID:28156293
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3066780/
Abstract

BACKGROUND

Decompressive craniectomy (DC) is often performed as an empirical lifesaving measure to protect the injured brain from the damaging effects of propagating oedema and intracranial hypertension. However, there are no clearly defined indications or specified guidelines for patient selection for the procedure.

AIMS

To evaluate outcome determinants and factors important in patient selection for the procedure.

METHODS

We reviewed the literature on DC, including single case reports and reported case series, to identify factors affecting outcome following the procedure, as well as its pitfalls and associated complications.

RESULTS

Glasgow coma score of 8 and above, age less than 50 years and early intervention were found to be among the most significant determinants of prognosis.

CONCLUSION

Improving patient selection for DC may be expected to further improve the outcome following the procedure in severely brain-injured patients.

摘要

背景

减压性颅骨切除术(DC)通常作为一种经验性的挽救生命的措施,以保护受伤的大脑免受进行性水肿和颅内高压的损害。然而,对于该手术的患者选择,没有明确界定的指征或特定的指南。

目的

评估该手术患者选择中的结局决定因素和重要因素。

方法

我们回顾了关于DC的文献,包括单例报告和报道的病例系列,以确定影响该手术后结局的因素,以及其陷阱和相关并发症。

结果

格拉斯哥昏迷评分8分及以上、年龄小于50岁和早期干预被发现是最重要的预后决定因素。

结论

有望通过改善DC的患者选择来进一步改善重度脑损伤患者手术后的结局。

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Decompressive craniectomy following brain injury: factors important to patient outcome.脑损伤后减压性颅骨切除术:对患者预后重要的因素。
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本文引用的文献

1
Outcomes of cranial repair after craniectomy.颅骨切除术后颅骨修复的结果。
J Neurosurg. 2010 May;112(5):1120-4. doi: 10.3171/2009.6.JNS09133.
2
Long-term outcome after suboccipital decompressive craniectomy for malignant cerebellar infarction.枕下减压颅骨切除术治疗恶性小脑梗死的长期预后
Stroke. 2009 Sep;40(9):3045-50. doi: 10.1161/STROKEAHA.109.550871. Epub 2009 Jul 2.
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Impact of decompressive craniectomy on functional outcome after severe traumatic brain injury.去骨瓣减压术对重度创伤性脑损伤后功能结局的影响。
J Trauma. 2009 Jun;66(6):1570-4; discussion 1574-6. doi: 10.1097/TA.0b013e3181a594c4.
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Complications of cranioplasty following decompressive craniectomy: analysis of 62 cases.减压性颅骨切除术后颅骨修补术的并发症:62例分析
Neurosurg Focus. 2009 Jun;26(6):E9. doi: 10.3171/2009.3.FOCUS0962.
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Complications of decompressive craniectomy for traumatic brain injury.创伤性脑损伤减压性颅骨切除术的并发症
Neurosurg Focus. 2009 Jun;26(6):E7. doi: 10.3171/2009.4.FOCUS0965.
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Long-term outcomes following decompressive craniectomy for severe head injury.严重颅脑损伤减压性颅骨切除术后的长期预后
Acta Neurochir Suppl. 2008;102:29-31. doi: 10.1007/978-3-211-85578-2_6.
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Decompressive craniectomy: a new complication.减压性颅骨切除术:一种新的并发症。
J Clin Neurosci. 2009 May;16(5):727-9. doi: 10.1016/j.jocn.2008.06.015. Epub 2009 Mar 3.
8
Contralateral subdural effusion secondary to decompressive craniectomy performed in patients with severe traumatic brain injury: incidence, clinical presentations, treatment and outcome.严重创伤性脑损伤患者行去骨瓣减压术后对侧硬膜下积液:发生率、临床表现、治疗及预后
Med Princ Pract. 2009;18(1):16-20. doi: 10.1159/000163040. Epub 2008 Dec 4.
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[Therapy of head trauma].[头部创伤的治疗]
Anaesthesist. 2008 Dec;57(12):1219-31. doi: 10.1007/s00101-008-1466-z.
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Surgical complications secondary to decompressive craniectomy in patients with a head injury: a series of 108 consecutive cases.颅脑损伤患者减压性颅骨切除术后的手术并发症:108例连续病例系列
Acta Neurochir (Wien). 2008 Dec;150(12):1241-7; discussion 1248. doi: 10.1007/s00701-008-0145-9. Epub 2008 Nov 13.