摘要
目的探讨采用损伤控制的方案治疗双额叶脑挫裂伤、脑内血肿的疗效。方法采用前瞻性的研究方法将100例双额叶脑挫裂伤、脑内血肿病人随机分组,对照组(n=50)仅根据CT及临床表现采用保守或常规手术治疗,研究组(n=50)根据病情逐步采取保守治疗→放置颅内压脑室型探头→单侧开颅手术入路清除双侧血肿→双侧开颅手术的手术方案。结果根据伤后6个月GOS预后评分判断两组预后差异无统计学意义(P>0.05)。与对照组比较,研究组去骨瓣比例明显下降(P<0.01),双侧开颅比例明显下降(P<0.01),但保守治疗差异无统计学意义(P>0.05)。结论采用损伤控制治疗双额叶脑挫裂伤、脑内血肿的手术方法由简单手术方案逐级到复杂手术过渡,能明显减少开颅及开颅带来的继发性损伤,减少脑中心疝的发生。
Objective To explore the therapeutic efficacy of damage control strategy for bilateral frontal cerebral contusion and intracerebral hematoma. Methods A hundred patients with bilateral frontal cerebral contusion and intracerebral hematoma were included in a prospective study and divided equally randomly into control group and research group. The patients received conservative or regular treatments in control group. According to the state of illness, the patients in research group orderly received conservative treatment, intracranial pressure ventricular type probe, unilateral craniotomy to evacuate the bilateral hematoma and bilateral craniotomy. Results There were no significant difference in prognosis between the two groups according to the GOS 6months after injury（P〉0.05）. Compared with control group, the rate of large trauma craniotomy obviously decreased（P〈0.01） and the rate of bilateral craniotomy decreased in research group（P〈0.01）, but there was no difference in conservative treatment between the two groups（P〉0.05）. Conclusion The damage control surgery for bilateral frontal cerebral contusion and intracerebral hematoma gradually undergoes the transition from simple to complex surgery, which can significantly reduce craniotomy and secondary injury and decrease the incidence of brain central hernia.
出处
《中国微侵袭神经外科杂志》
CAS
2015年第9期402-404,共3页
Chinese Journal of Minimally Invasive Neurosurgery
关键词
颅脑损伤
额叶
血肿
损伤控制
颅内压监测
入路
单侧
大脑镰切开
craniocerebral trauma
frontal lobe
hematoma
damage control
intracranial pressure monitoring
approach
unilateral
cerebral falx incision
