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目的探讨去骨瓣减压术后交通性皮瓣下积液的治疗方法。方法回顾性分析13例颅脑损伤去骨瓣减压术后发生交通性皮瓣下积液病人的临床资料,采用腰大池-腹腔(lumboperitoneal,L-P)分流术。CT检查皮瓣下积液最大层面厚度为(38.52±6.09)mm。GCS评分(6.73±2.37)。结果术后13例病人皮瓣下积液最大层面厚度为(3.94±2.70)mm,小于分流前积液厚度(P<0.05);GCS评分(9.09±2.95),明显高于分流前评分(P<0.05)。随访13例,时间1~12个月。11例意识障碍病人中,意识恢复正常3例,好转6例,无变化2例;7例瘫痪病人中,肌力明显提高4例,无变化3例;3例呕吐病人症状好转。术后无感染、出血等并发症。结论 L-P分流治疗外伤性去骨瓣减压术后交通性皮瓣下积液疗效确切。
Objective To investigate the treatment of traumatic subcontract effusions after decompressive craniectomy. Methods The clinical data of 13 patients with traumatic subalvular effusions after decompressive craniocerebral injury were retrospectively analyzed. The lumbo - peritoneal (L - P) shunt was performed. CT examination of the maximum thickness of the effusion under the flap (38.52 ± 6.09) mm. GCS score (6.73 ± 2.37). Results The maximum thickness of effusion under the flap was (3.94 ± 2.70) mm in 13 patients, less than the thickness of the effusion before shunt (P <0.05). The GCS score (9.09 ± 2.95) was significantly higher than that before shunt <0.05). Follow-up of 13 cases, time of 1 to 12 months. Of the 11 patients with disturbance of consciousness, 3 returned to normal, 6 improved, and 2 remained unchanged. Among the 7 patients with paralyzed condition, the muscle strength increased significantly in 4 patients and no change in 3 patients. The symptoms of 3 vomiting patients improved. No postoperative infection, bleeding and other complications. Conclusion L-P shunt treatment of traumatic debridement flap after traumatic traffic effusion is effective.