目的 探讨术中控制性减压对儿童重型颅脑损伤的治疗作用。方法 122例儿童重型颅脑损伤需要开颅手术减压患者,术中随机分成控制性减压手术研究组(60例)和常规手术治疗对照组(62例)进行治疗,观察两组患者术后脑梗死的发生率及预后。结果 研究组术后脑梗塞发生率为6.7％(4例),低于对照组的17.7％(11例)(P<0.05);术后6个月采用GOS标准进行预后判定,治疗组不良预后(重残、植物状态、死亡)有9例占15.0%,低于对照组的23例(37.1%)(P<0.05)。结论 术中采用控制性减压能减少儿童重型颅脑损伤患者术后脑梗塞的发生率及明显改善患者的预后。

Objective To investigate the clinical efficacy of intraoperative controlling decompression in treating of severe craniocerebral injuries in children. Methods 122 cases of severe craniocerebral injuries in children who needed surgical decompression by craniotomy were randomly divided into control decompression surgical group(60 cases)and conventional surgical group(62 cases).The incidence of postoperative cerebral infarction and the outcome according to GOS scores after 6 months were observed in two groups. Results The incidence of postoperative cerebral infarction was 6.7% in controlling decompression surgical group and 17.7% in conventional surgical group. The differences between two groups were statistical significant(P<0.05); The all poor prognosis patients(severely disabled, vegetative state and death) were 9 cases in controlling decompression surgical group and 23 cases in conventional surgical group. The differences between two groups were statistical significant(P<0.05). Conclusion Intraoperative controlling decompression can significantly reduced the incidence of postoperative cerebral infarction and improved the poor prognosis patients of severe craniocerebral injuries in children.