标准大骨瓣减压术并带蒂颞深筋膜瓣硬脑膜修复术在重型颅脑损伤中的应用价值

摘要

Objective To analyze the standard decompressive craniectomy and pedicle deep temporal fascia dural repair the treatment of severe traumatic brain injury with complications, and explore its value. Method Chose our hospital for treatment of 90 patients with severe craniocerebral injury, they were divided into observation group and control group, 45 cases in each group. Observation group was given standard big bone lfap decompression craniocerebral injury and pedicle deep temporal fascia lfap of dura repair treatment, control group only for craniocerebral injury standard big bone flap decompression therapy. Observed two groups of therapeutic effect and complications. Result The treatment of good in 33 cases (73.33%), severe disability in 3 cases (6.67%), plant survival 1 case (2.22%), 8 cases (17.78%) died; well to treatment in control group 19 cases (42.22%), severe disability in 6 cases (13.33%), plant survival 3 cases (6.67%), 17 patients died (37.78%). Wound infection in 1 case of observation group (2.22%), cerebrospinal lfuid leakage in 2 cases (4.44%), seroma 5 cases (11.11%), brain incarcerated 3 cases (6.67%), epilepsy 3 cases (6.67%);control group wound infection in 8 cases (17.78%), cerebrospinal lfuid leakage in 9 cases (20.00%), seroma in 21 cases (46.67%), brain incarcerated in 11 cases (24.44%), seizures in 13 cases (28.89%). Conclusion Decompressive craniectomy and pedicle deep temporal fascia dural repair the treatment of severe traumatic brain injury rate is higher good, low mortality and low complication rate, it is worth promoting.%目的：分析标准大骨瓣减压术并带蒂颞深筋膜瓣硬脑膜修复术治疗重型颅脑损伤的临床效果与并发症情况，探讨其应用价值。方法选取本院收治的重型颅脑损伤患者90例，将其分为观察组与对照组，每组各45例。观察组患者给予标准颅脑损伤大骨瓣减压术并带蒂颞深筋膜瓣硬脑膜修复术治疗，对照组患者仅给予标准颅脑损伤大骨瓣减压术治疗。观察两组患者治疗效果与并发症发生情况。结果观察组患者治疗良好33例（73.33%），重残3例（6.67%），植物生存1例（2.22%），死亡8例（17.78%）；对照组患者治疗良好19例（42.22%），重残6例（13.33%），植物生存3例（6.67%），死亡17例（37.78%）。观察组患者切口感染1例（2.22%），脑脊液漏2例（4.44%），皮下积液5例（11.11%），脑嵌顿3例（6.67%），癫痫3例（6.67%）；对照组患者切口感染8例（17.78%），脑脊液漏9例（20.00%），皮下积液21例（46.67%），脑嵌顿11例（24.44%），癫痫13例（28.89%）。结论标准大骨瓣减压术并带蒂颞深筋膜瓣硬脑膜修复术治疗重型颅脑损伤良好率较高、病死率较低，且并发症发生率较低，值得临床推广应用。