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目的 总结阶梯状逐层开颅联合序贯控制减压用于重型脑挫伤去骨瓣减压术的应用效果.方法 将62例重型脑挫伤患者随机分为常规开颅减压术组(A组,20例)、序贯控制减压手术组(B组,20例)和阶梯状逐层开颅联合序贯控制减压手术组(C组,22例),比较三组的临床治疗效果.结果 C组术后恢复良好率高于A组和B组(63.64％ vs.10.00％和20.00％)(P＜0.05).C组并发症发生率低于A组和B组(22.73％vs.80.00％和35.00％)(P＜0.05).结论 在重型脑挫伤去骨瓣减压术中应用阶梯状逐层开颅联合序贯控制减压的临床效果良好,并发症较少.“,”Objective To summarize the clinical efficacy of stepped craniotomy combined with sequential control decompression in the decompressive craniectomy of patients with severe cerebral contusion.Methods Sixty-two patients with severe cerebral contusion were randomly divided into three groups.The patients in group A were operated by conventional craniotomy(20 cases),those in group B were operated by sequential control decompression (20 cases),and those in group C were operated by stepped craniotomy combined with sequential control decompression (22 cases).The clinical outcomes were compared among three groups.Results The good rate of recovery after operation in group C was higher than that in groups of A and B(63.64％ vs.10.00％ and 20.00％) (P＜0.05).The incidence of complications in group C was lower than that in groups of A and B (22.73％ vs.80.00％ and 35.00％) (P＜0.05).Conclusion Combination use of stepped craniotomy and sequential control decompression in the treatment of severe cerebral contusion undergoing decompressive craniectomy has satisfactory clinical outcomes and less incidence of postoperative complications.