控制性减压术防治老年重型颅脑损伤并发脑梗死的可行性研究

1、控制性减压术防治老年重型颅脑损伤并发脑梗死的可行性研究【摘要】目的：研究控制性减压术对防治老年重 型颅脑损伤并发脑梗死的可行性。方法：收集老年重型颅脑 损伤患者共60例，对照组30例患者采用标准大骨瓣减压术, 观察组30例患者采用控制性减压术。术后统计两组患者的 手术效果，患者有无脑水肿及其严重程度，患者有无脑梗死 及其体积大小，术后48 h两组患者双侧大脑中动脉血流动 力学及术后6个月的恢复情况。结果：观察组总有效率为 96. 67%,比对照组的76. 67%高。观察组脑水肿发生率为 16. 67%,明显低于对照组的36. 67%o脑梗死的发生率为 6.67%,亦低于对照组的23. 33%o

2、结论：控制性减压术防治 老年重型颅脑损伤是可行的。【关键词】控制性减压术；重型颅脑伤；脑梗死中图分类号r743文献标识码b文章编号1674-6805 (2014) 31-0134-02controlling decompression feasibility study in elderly patients with cerebral infarction with severe brain injury prevention/hu xiao-min , liu kun , tan cong. /chinese and foreign medical research, 2014, 12 (

3、31)： 134-135abstract objective： to study the prevention and treatment of senile controlled decompression surgery for severe brain injury complicated by cerebral infarction feasibility.method : period in elderly patients with severe traumatic brain injury , namely control group and observation group

4、and control group of 30 patients were treated with standard large trauma reduction buckling surgery, observation group of 30 patients were treated with controlled decompression. generally two groups of patients with postoperative statistical effect , whether patients with cerebral edema and its seve

5、rity, whether patients with cerebral infarction and its dimensions, after 48 h after the two groups of patients with bilateral cerebral hemodynamics and arterial blood recovery after 6 months .result： the total effective rate of the observation group was 96.67%, was higher than the control group&quo

6、t; s 76. 67%.the cerebral edema incidence of the observation group was 16. 67%, was significantly lower than the control group， s 36. 67%. the edema incidence of cerebral infarction of the observation group was 6. 67%, was lower than the control group" s 23.33%.conclusion： controlling decompres

7、sion severe brain injury prevention in elderly is clinically feasible .key words controlling decompression； severe traumatic brain injury； cerebral infarctionfirst-author' s address： wusheng county people' s hospital, wusheng 638400, china重型颅脑损伤发生多由于高能创伤使得颅内血肿挤压、 创伤后脑水肿加重、颅内压急剧增髙，从而引起脑的进一步 损

8、伤，严重的可导致死亡1-3 o目前神经外科常用的减压 手段有标准外伤大骨瓣减压术和控制性减压术，而标准外伤 大骨瓣减压术防治脑梗死的效果不是很理想4-5。本研究 通过对收集的患者采用标准大骨瓣减压术和控制性减压术 治疗，多数患者经治疗后病情好转情况好于以标准大骨瓣减 压术治疗的患者。2010年8月-2012年8月笔者所在医院老 年重型颅脑损伤患者60例，采用标准大骨瓣减压术和控制 性减压术对其进行治疗，现报告如下。1资料与方法1. 1 一般资料收集老年重型颅脑损伤患者共60例，均无严重心血管 疾病、肝肾功能障碍、药物过敏史以及近期输血史。其中男 35例，女25例：根据病因分为车祸（26例），高空坠落（26 例），打击伤（14例）；根据病情可分为广泛脑挫裂伤（20 例