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目的:总结根据脑挫裂伤合并脑内血肿以及意识变化的情况,及时采用合理的手术方法的效果。方法:回顾36例重度脑挫裂伤合并脑内血肿的患者,采用单侧颞瓣15例,单侧额瓣10例,单侧额颞瓣5例,双侧额瓣4例,双侧扩大骨瓣2例,发病至手术时间1例是10 d,1例9 d,1例4 d,1例3 d,其余均在6 h之内。结果:本组36例手术治疗后死亡6例,植物生存1例,肢体偏瘫6例,有较重的精神症状10例,轻度精神症状4例,仅有6例无明显后遗症状。有3例术后并发脑积水,做脑室-腹腔分流术。结论:早期诊断,早期手术治疗,是挽救患者生命的必要选择。
OBJECTIVE: To summarize the effect of timely and reasonable surgical methods according to the situation of brain contusion and brain hematoma and consciousness changes. Methods: Thirty-six patients with severe brain contusion and intracerebral hematoma were retrospectively reviewed. Fifteen cases of unilateral temporal lobe, 10 cases of unilateral peduncular lobe, 5 cases of unilateral frontotemporal lobe, 4 cases of bilateral lobe, bilateral enlargement There were 2 cases of bone flap, one case was onset of operation to 10 days, one case of 9 days, 1 case of 4 days, 1 case of 3 days, the rest were within 6 hours. Results: Sixty-six patients died after surgery in this group. One case of plant survival and six cases of hemiplegia were found. There were 10 severe psychiatric symptoms and 4 mild psychiatric symptoms. Only 6 patients had no obvious sequelae. There are 3 cases of postoperative hydrocephalus, so intraventricular - peritoneal shunt. Conclusion: Early diagnosis and early surgical treatment are the necessary choices to save the patient’s life.