简介：　　 [摘要 ] 目的 研究分析重型脑外伤合并脑疝实施标准大骨瓣减压并天幕切开术治疗的效果。方法 此次研究的对象是选取 2018年 4月— 2019年 5月该院收治的重型脑外伤合并脑疝患者 100例，将其临床资料进行回顾性分析，按照随机数字分组法分为 2组，一组患者采用标准大骨瓣减压术治疗，称为对照组，另一组患者采用标准大骨瓣减压并天幕切开术治疗，称为观察组，观察两组重型脑外伤合并脑疝患者的治疗效果。结果 观察组重型脑外伤合并脑疝患者的脑干周围池改善率（ P<0.05， χ2=9.5426）、术后 3周（ t=11.1840， P<0.05）、 6周（ t=26.0610， P<0.05）及 8周（ t=47.8285， P<0.05）的 GCS评分明显优于对照组（ P<0.05）。结论 重型脑外伤合并脑疝实施标准大骨瓣减压并天幕切开术治疗效果显著，能够有效改善脑干缺血状态，提高预后质量。  　　 [关键词 ] 重型脑外伤合并脑疝；标准大骨瓣减压并天幕切开术；效果  　　 [Abstract] Objective To study and analyze the effect of standard large bone flap decompression and tentorium incision in the treatment of severe brain injury combined with brain hernia. Method The object of this study is to select 100 patients with severe brain injury and brain hernia who were admitted to the hospital from April 2018 to may 2019, and analyze their clinical data retrospectively. According to the random number grouping method, they are divided into two groups. One group is treated by standard large flap decompression, which is called the contrast group, the other group is treated by standard large flap decompression and tentorium incision, which is called the observation group To observe the therapeutic effect of two groups of patients with severe brain injury combined with brain hernia. Results the GCS scores of severe brain injury patients with brain hernia in the observation group (P < 0.05, χ 2 = 9.5426), 3 weeks (t = 11.1840, P < 0.05), 6 weeks (t = 26.0610, P < 0.05) and 8 weeks (t = 47.8285, P < 0.05) were significantly better than those in the control group (P < 0.05). Conclusion the standard large bone flap decompression combined with tentorium incision can effectively improve the state of brainstem ischemia and the quality of prognosis.

简介：　　【摘要】目的 了解硬脑膜网状切开在合并急性脑肿胀的脑外伤手术中的应用价值。方法 对我院 2017年 3月至 2019年 3月收治的合并急性脑肿胀的脑外伤患者进行抽样，选取 68例患者随机分成两组，对照组予以常规去骨瓣减压术进行治疗，实验组应用硬脑膜网状切开术进行治疗，观察两组患者临床疗效。结果 实验组术后病死率（ 8.82%）明显低于对照组（ 35.29%），且存活患者残疾率（ 52.94%）显著优于对照组（ 85.29%），差异具有显著统计学意义（ P<0.05）。结论 硬脑膜网状切开在合并急性脑肿胀的脑外伤手术中具有重要的应用价值，值得临床大力推广使用。  

简介：　　摘 要：目的 探讨早期颅骨修补治疗脑外伤的临床疗效。方法 此次研究的对象是选择 2018年 1月～ 2020年 1月于我院脑外科就诊治疗的脑外伤患者 108例，将其临床资料进行回顾性分析，并随机分为研究组和参考组两组，每组 54例。研究组进行早期颅骨修补术，参考组进行晚期颅骨修补术。分析对比两组患者的治疗效果以及手术前后的神经功能缺损程度和日常生活能力评分情况。结果 研究组患者的整体治疗有效率（ 94.44%）显著高于参考组（ 66.67%），差异有统计学意义（ P<0.05）；研究组患者术后神经功能缺损程度评分为（ 14.3±3.6）分，低于参考组的（ 19.2±4.5）分，研究组患者术后日常生活能力评分为（ 74.2±12.7）分，高于参考组的（ 53.4±12.9）分，两组患者相比，差异有统计学意义（ P<0.05）。结论 早期颅骨修补治疗脑外伤比晚期颅骨修补术的治疗效果更为良好，同时能够有效提高患者的神经功能与日常生活能力，值得临床推广与应用。  　　关键词：早期颅骨修补术；晚期颅骨修补术；脑外伤  Abstract: Objective To explore the clinical effect of early skull repair in the treatment of brain injury. Methods 108 patients with brain injury who were treated in brain surgery of our hospital from January 2018 to January 2020 were selected in this study, and their clinical data were analyzed retrospectively. They were randomly divided into study group and reference group, 54 cases in each group. In the study group, early cranioplasty was performed, while in the reference group, late cranioplasty was performed. To analyze and compare the therapeutic effect of the two groups, the degree of neurological deficit and the score of daily living ability before and after operation. Result The total effective rate of treatment in the study group (94.44%) was significantly higher than that in the reference group (66.67%), the difference was statistically significant (P < 0.05); the score of neurological deficit degree in the study group was (14.3 ± 3.6), lower than that in the reference group (19.2 ± 4.5), and the score of daily living ability in the study group was (74.2 ± 12.7), higher than that in the reference group (53.4 ± 12.9) The difference between the two groups was statistically significant (P < 0.05). Conclusion the effect of early cranioplasty is better than that of late cranioplasty, and it can improve the nerve function and daily life of patients, which is worthy of clinical application.

简介：　　【摘要】 目的 探讨显微镜下小骨窗开颅手术治疗高血压脑出血的疗效。方法 对 28例高血压脑出血患者应用显微镜进行小骨窗开颅手术， 经皮层造瘘显微镜下清除脑内血肿， 观察治疗效果。结果 28例患者术后立即复查头颅 CT， 显示手术清除血肿量 >75%。所有患者随访 3个月～ 1年， 按日常生活能力（ ADL）分级进行统计与评价， 恢复良好率为 75%。结论 显微镜下小骨窗开颅手术治疗高血压脑出血是治疗高血压脑出血有效的方法之一， 疗效好， 创伤少， 可提高治愈率， 降低死亡率及并发症发生率。  　　【关键词】 高血压脑出血；小骨窗开颅手术；显微镜  [Abstract] Objective To explore the effect of microscopically small bone window craniotomy in the treatment of hypertensive cerebral hemorrhage. Methods 28 patients with hypertensive intracerebral hemorrhage were operated by microsurgery with small bone window, and the hematoma was removed by microsurgery through cortical fistulation. Results in 28 patients, CT scan showed that the amount of hematoma removed was more than 75%. All patients were followed up for 3 months to 1 year. According to ADL classification, the recovery rate was 75%. Conclusion microscopically small bone window craniotomy is one of the effective methods in the treatment of hypertensive cerebral hemorrhage. It has good curative effect and less trauma, which can improve the cure rate and reduce the mortality and complications.