To analysis the treatment effection of 53 cases of cranial decompression under temporal muscle in very-low position with large bone flap for severs cranial trauma / 中国基层医药

ABSTRACT

Objective To investigate the treatment effection of cranial decompression under temporal muscle in very-low position with large bone flap for severe cranial trauma.Methods 53 cases of severs cranial traumatic brain herniation were derided into two groups.22 cases with unilateral dilated pupil,and 31 cases of bilateral dilated pupil,all the patients were treated with cranial decompression under temporal muscle in very low position with large bone-flap.The ICP,appearance rate of cisternal,pupil contraction rate and GCS evaluation were observed,recorded and statistiely analysised.Results According to the intraeranial pressure monitoring,the rate of 24h ICP＜20mmHg was increased significantly,and the rate of 72h ICP＞40mmHg was decreased in both groups.The occurance rate of cisternal:81.82% in unilateral dilated pupil group,and 51.61% in bilateral dilated pupil group.The recoverance rate of pupil in 24h:77.2% in unilateral dilated pupil group,and 32.26% in bilateral dilated pupil group.GCS evaluation:All of the patient's average mark of GCS after operation wag(8.02±3.03)which increased(3.92±2.21)compared with the mark of GCS before operation,which was(4.10±0.82),with a significant difference(P＜0.01).Treat outcome:well/moderate disability:64.15%,severe/long-term coma:7.55%,and death:28.30%.Conclusion Cranial decompression under temporal muscle in very-low position with large bone-flap for severe cranial trauma can enlarge the cranial capacity effectively,increase the decompression space in dorsolateral cranium,which can alleviate the intracranial pressure in axial centre of brain truak,promote the effeetion of the brain herniation restore and the recover of the brain trauma.