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目的探讨硬脑膜补片在重型颅脑损伤去骨瓣减压术中的临床应用。方法78例额颞叶脑挫裂伤患者,随机分为A组40例行去骨瓣减压术同步行硬脑膜补片修补硬膜和B组38例行去骨瓣减压硬膜敞开。比较术后并发症的情况、术后半年随访患者GOS情况。结果A组并发脑膨出(0)、脑室穿通畸形(2.5%)、硬膜下或皮下积液(17.5%)、脑脊液漏(5%)、颅内感染(7.5%)明显低于B组;半年后评价A组GOS评分明显高于B组。结论重型颅脑损伤去骨瓣减压术中应用硬脑膜补片修补硬膜,可以减少术后并发症,改善患者愈后,该方法操作简单,值得临床推广。
Objective To investigate the clinical application of dural patch in decompressive craniectomy with severe craniocerebral injury. Methods A total of 78 patients with frontotemporal lobe contusion and laceration were randomly divided into group A (40 cases) underwent decompressive craniectomy with dural flap repair, and group B (38 cases) underwent decompressive dural opening. Comparisons of postoperative complications, postoperative six-month follow-up of patients with GOS. Results In group A, encephalocele (0), ventricular puncture deformity (2.5%), subdural or subcutaneous effusion (17.5%), cerebrospinal fluid leakage (5%) and intracranial infection (7.5%) were significantly lower than those in group B Six months after the evaluation group A GOS score was significantly higher than the B group. Conclusion In the treatment of severe craniocerebral injury with decompressive craniectomy, the dural patch can be used to repair the dura mater, which can reduce the postoperative complications and improve the prognosis of the patients. The method is simple in operation and worthy of clinical promotion.