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目的脑室穿刺引流在双额叶脑挫裂伤后弥漫性脑肿胀治疗中的作用。方法观察组47例,全部进行颅内压监护,一旦颅内压持续超过270cmH2O,出现弥漫性脑肿胀征兆,即行单侧或双侧侧脑室穿刺引流术。对照组50例,根据脑肿胀的程度予以强化脱水等保守治疗或标准大骨瓣减压术,严重者同时行内减压术。结果观察组死亡3例,占6%,恢复良好44例,对照组死亡9例,占18%,植物生存0例,重残0例,中残3例,恢复良好38例。结论脑室穿刺引流是一种有效的微创治疗方法,可以有效缓解双额叶挫裂伤后的弥漫性脑肿胀,降低死亡率,值得推广。
Purpose of ventricle puncture and drainage in the treatment of diffuse brain swelling after double frontal lobe contusion and laceration. Methods 47 cases of observation group, all of intracranial pressure monitoring, once the intracranial pressure continued to exceed 270cmH2O, diffuse signs of brain swelling, that unilaterally or bilateral ventricular puncture and drainage. Control group of 50 patients, according to the extent of brain swelling to be conservative treatment of intensive dehydration or standard large flap decompression, severe cases at the same time underwent decompression. Results In the observation group, 3 cases died, 6% recovered, 44 cases recovered well, 9 cases died in the control group, accounting for 18%. There were 0 cases of plant survival, 0 cases of severe disability, 3 cases of residual disability and 38 cases of recovery. Conclusions Ventricular puncture and drainage is an effective and minimally invasive treatment, which can effectively relieve diffuse brain swelling and reduce mortality after double frontal lobe contusion and laceration. It is worth to be popularized.