目的：探讨冠状切口两侧大骨瓣减压术临床应用价值。方法回顾性分析2014年1月至12月11例冠状切口两侧大骨瓣减压术患者及9例两侧分次大骨瓣减压患者的临床资料，比较术中脑膨出发生率、术前GCS评分和术后GOS评分。结果冠状切口两侧大骨瓣组未发生术中脑膨出，两侧分期大骨瓣减压组术中脑膨出发生率66.6%，两组比较差异有统计学意义；两组术前GCS评分比较差异无统计学意义；两组术后1个月GOS评分比较差异无统计学意义。结论弥漫性脑肿胀患者采用冠状切口两侧外伤大骨瓣减压可以降低甚至避免脑膨出，是否可以改善患者预后需要增加病例数以进一步研究。%Objectives To explore whether intraoperative brain swelling could be less with coronal incision bilateral standard trauma craniectomy than staged bilateral standard trauma craniectomy. Methods A retrospectively comparion were performed, in terms of preoperative glascow coma scores,frequency of intraoperative brain swelling and glascow outcome scores of the patients hospitalized during Jan. 1 2014 to Dec. 31 2014, in the total of 11 cases,whose computer tomography indicated diffuse brain swelling or bilateral frontal and temporal contusion combined with thin subdural hematoma,having been performed of coronal incision bilateral standard trauma craniectomy,with those of the patients,in the total of 9 cases,hospitalized during same period,whose computer tomography indicated similar lesions. The period of follow-up varied from 1 day to 1 year. Results No intraoperative brain swelling occurred during operations with coronal incision bilateral standard trauma craniectomy,while there were 6 cases of intraoperative brain swelling with staged bilateral standard trauma craniectomy. Statical difference was found between the two groups in comparison of the frequency of intraoperative brain swelling. While no statical difference was found in comparison of glascow comma score or glascow outcome score. Conclusions In the patients with diffuse brain swelling,intraoperative brain swelling occurs less with coronal incision bilateral standard trauma craniectomy than staged bilateral standard trauma craniectomy.
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