单侧入路大脑镰切开清除双额底脑挫伤手术探讨

摘要

Objective To explore the feasibility of unilateral craniotomy for cerebral contusion in bilateral frontal lobes complicated with local hematoma via fronto-cerebral falx incision approach and the clinical curative effect. Methods A retrospective analysis was made to the clinical data of 15 cases with cerebral contusion who received unilateral craniotomy in the period from June, 2011 to Jan. ,2013. Results Hematoma and necrotic brain tissues in bilateral frontal lobes,left in 9 cases and right in 6 cases,were removed under direct vision;postoperative CT scanning showed out a satisfactory removal of the hematoma;follow-up lasted for 3 months,and GOS revealed good recovery in 11 cases,mild disability in 2 cases and severe disability in 1 case;1 case died. Conclusions It is feasible to perform unilateral craniotomy for cerebral contusion in bilateral frontal lobes,which can obviously decrease the mortality and disability rate of the patients with severe cerebral contusion.%目的：探讨一侧入路清除双侧额底脑挫裂伤伴局部血肿的可行性及临床疗效。方法对我院2011年6月~2013年1月年共15例经损伤较重的一侧入路清除双额底脑挫伤的患者进行回顾性研究。结果术中均直视下清除双侧额底脑内血肿及挫伤坏死脑组织，其中左侧9例，右侧6例，术后 CT 检查提示脑挫伤血肿清除满意。伤后随访3个月，根据 GOS分级标准评定，恢复良好11例，中残2例，重残1例，死亡1例。结论经单侧入路清除双额底脑挫伤可行，能显著降低重型颅脑损伤患者的死亡率和致残率。