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目的评估幕上下联合去骨瓣减压术治疗重型颅脑损伤的手术适应症及疗效。方法对31例重型颅脑损伤病人均实施幕上下联合去骨瓣减压术。结果按格拉斯哥预后评分(GOS):恢复良好11例,中度残疾5例,重度残疾2例,植物生存4例,死亡9例,死亡率29.0%。结论对合并有幕下病变的重型颅脑损伤早期实施幕上下联合去骨瓣减压术能有效改善病人预后,提高生存率。在严格掌握手术适应症的同时,幕上进行减张缝合硬脑膜,幕下敞开硬脑膜并留置引流是值得提倡的手术措施。
Objective To evaluate the surgical indications and curative effects of combined supratentorial and ciliary decompression on severe craniocerebral injury. Methods A total of 31 patients with severe traumatic brain injury were treated with supratentorial decompression. Results According to the Glasgow Outcome Scale (GOS), 11 were well recovered, 5 were moderately disability, 2 were severe disability, 4 were plant-based, 9 were fatal, and 29.0% were fatal. Conclusion The combination of supratentorial decompression and biliary decompression can effectively improve the prognosis and improve the survival rate of patients with severe craniocerebral injury with infratentorial lesions. Strict control of surgical indications at the same time, the curtain to suture the dural suture, dural open dural and indwelling drainage is worth promoting the surgical measures.