摘要
目的对颅脑外伤去大骨辩减压术后并发脑膨出、颅内血肿及脑梗死的情况进行临床分析。方法选取2012～2013年接受诊治的56例颅脑外伤并行大骨辫减压术的患者作为研究对象。于术后8周后对所有患者进行格拉斯哥预后评分，统计分析各级患者并发脑膨出、颅内血肿及脑梗死的情况。结果颅脑外伤经去大骨瓣减压术后并发脑膨出患者43例（76．8％），并发颅内血肿患者32例（57．1％），并发脑梗死患者7例（12．5％）。并发脑膨出患者在术后1周至2周期间脑膨出情况明显加重，且差异具有统计学意义（t=17．4772，P=0．0001）。56例患者有32例并发脑内血肿或（和）脑挫裂伤扩大的情况，其中96．9％的患者于术后3d内即出现病灶。术后共有12例（21．4％）患者并发脑梗死，预后不良组与预后良好组脑梗死发生率差异具有统计学意义（x^2=4．384，P=0．043）。结论颅脑外伤去大骨瓣减压术后易并发脑膨出、颅内血肿及脑梗死，是ll占床致死、致残的主要因素之一，其中以脑梗死对患者预后不良影响最为明显。临床上对颅脑外伤患者手术应严格掌握手术适应证，尽可能减少术后并发症。
Objective To analyze the clinical expression of craniocerebral trauma patient complicated with encephalocele, intracranial he- matoma and cerebral infarction after decompressive craniectomy. Methods 56 patients of craniocerebral trauma were included into this study. All patients were diagnosed and treated with decompressive craniectomy in our hospital between 2012 - 2013, as the research object. All patients were taken GOS grade at postoperative 8 weeks, statistical analysis at all levels of patients with concurrent encephalocele, intracranial hematoma and cerebral infarction, gmults After deeompressive craniectomy, craniocerebral trauma with concurrent encephalocele were 43 cases （76.8 % ）, 32 cases （57. 1 % ） with intracranial hematoma patients, and 7 cases （12.5%） with cerebral infarction patients. Comparing patients with postoperative 1 week and 2 weeks after contrast encephalocele, patients in the postoperative period 1 to 2 week bulging diencephalon is significantly increased. The difference is statistically significant （ t = 17. 4772, P =0. 0001 ）. 32 in 56 cases complicated with brain hematoma or （and） cere- bral contusion of expanding. 96.9% of the patients was postoperative 3 d within the lesion. After a total of 12 cases （21.4%） patients complicated with cerebral infarction, the difference is statistically significant between GOS Ⅰ -Ⅲand GOS Ⅳ - Ⅴ two groups （x^2 = 4. 384, P = 0. 043 ）. Conclugiott Graniocerebral trauma to the big bone flap decompression with can complicate concurrent encephalocele, intracranial hematoma and cerebral infarction. In all these complications, cerebral infarction is one of the main factors of clinical death and disability, of which the most influence on prognosis in patients was cerebral infarction, Therefore, the clinical surgery in patients with craniocerebral trauma should master the opera- tion indications strictly, as far as possible to reduce the postoperative complications.
出处
《临床和实验医学杂志》
2014年第12期998-1001,共4页
Journal of Clinical and Experimental Medicine
关键词
颅脑外伤
去大骨瓣减压术
脑膨出
颅内血肿
脑梗死
Craniocerebral trauma
Decompressive craniectomy
Encephalocele
Intracranial hematoma
Cerebral infarction
