摘要：目的 探讨低位大骨瓣开颅术治疗额颞顶部广泛对冲伤的临床应用价值.方法 采用低位大骨瓣开颅术对46例额颞顶部广泛对冲伤患者进行手术治疗,术后3~6个月采用格拉斯哥预后分级标准进行临床疗效的评定,并对并发症进行分析.结果 46例中预后良好22例(47.83%),中度残疾6例(13.04%),重度残疾4例(8.7%),死亡14例(30.43%),术后主要并发症为迟发性颅内血肿、脑穿通畸形、脑积水、颅骨缺损综合征等.结论 低位大骨瓣开颅术是治疗额颞顶广泛对冲伤(尤其是单侧)的良好手术方式. Abstract： Objective To evaluate the value of low large trauma craniotomy in frontotemporal and parietal contrecoup craniocerebral injury. Methods Forty-six patients with frontotemporal and parietal contrecoup craniocerebral injury were treated by low large trauma craniotomy. Based on GCS, the clinical curative effect and complications of these patients during 3 to 6 months after operation were evaluated. Results Twenty-two cases (47.83%)recovered well, 6 cases(13.04%)suffered from moderate disability, 4 cases(8.7%) remained severe disability, and 14 cases (30.43%) died. The common comlications after operation were delayed intracranial hematoma, cerebral penetrating malformation, hydrocephalus, defect of skull syndrome and so on. Conclusions Low large trauma craniotomy is a good therapeutic method for frontotemporal and parietal contrecoup craniocerebral injury.

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