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目的治疗重型颅脑损伤。方法标准外伤大骨瓣开颅,清除各种颅内血肿和坏死脑组织,实施内减压,并去除额颞顶部大骨瓣减压。结果实施标准外伤大骨瓣开颅术治疗重型颅脑损伤46例,单侧为主,其中一侧额颞顶部脑挫裂伤并硬膜下血肿或(和)脑内血肿25例,一侧额颞顶部单纯急性硬膜下血肿11例,一侧额颞顶部硬膜外血肿并脑挫裂伤或(和)脑内血肿6例,单纯脑内血肿4例,术后效果良好27例,中残7例,重残6例,植物生存4例,死亡2例。结论用标准外伤大骨瓣开颅术治疗单侧重型颅脑损伤,能基本彻底清除幕上颅内血肿,充分减压,降低死亡率和至残率。
Objective To treat severe craniocerebral injury. Methods Standard trauma craniotomy craniotomy, removal of various intracranial hematomas and necrotic brain tissue, the implementation of decompression, and removal of frontoparietal large lobe decompression. Results The implementation of standard trauma craniectomy in 46 cases of severe craniocerebral injury, unilateral-based, one frontal frontotemporal cerebral contusion and subdural hematoma or (and) intracerebral hematoma in 25 cases, one side The frontal frontal simple acute subdural hematoma in 11 cases, frontal frontotemporal epidural hematoma and cerebral contusion or (and) intracerebral hematoma in 6 cases, simple intracerebral hematoma in 4 cases, good results in 27 cases, In the residual 7 cases, 6 cases of severe disability, plant survival in 4 cases, 2 cases of death. Conclusion Standard craniotomy with large trauma craniotomy for unilateral severe craniocerebral injury can basically completely remove the supratentorial intracranial hematoma, decompression, reduce mortality and morbidity.