【摘要】 目的 探讨高原额颞部重型颅脑损伤的改进手术方法及效果。方法 采用改良式Kelly问号形切口，沿前额发际内正中旁3cm，向后呈弧形在顶骨结节前转向颞部到达乳突上缘，从耳后发际边缘拐向前缘止于颧弓上。从颞骨鳞部开窗，颅骨钻孔取下扩大骨瓣，切开硬脑膜，清除血肿及挫碎脑组织。同时去骨瓣减压，将骨瓣浸泡在55%酒精瓶内密封低温冷藏。结果 本组46例患者经手术治疗后存活36例，良好28例，中度残废6例，重度残废2例；死亡10例。结论 46例患者采用改进手术方法扩大入路硬脑膜成形术治疗额颞部重型颅脑损伤，存活36例，取得了较好的效果。

     【关键词】 重型颅脑损伤；额颞部；改进手术方法

    Using the improving surgery method to treat heavy craniocerebral trauma of frontal and temporal part

    ZHANG Yuan,LI Jian-xun,SHI Cun-lan.Department of Neurosurgery,No 536 Hospital of PLA,Xining,Qinghai 810007,China

    【Abstract】 Objective To study the improving surgery method and effect about plateau heavy craniocerebral trauma of frontal and temporal part.Methods Use of the improving type Kelly question mark shape incision,along the forehead hair center side 3cm,adopt the arc shape back to arrive the mastoid upper part in the parietal bone tubercle anteversion to temporal part,along the border edge after the ear to turn to the front edge to the arcus zygomaticus.Open a window from the scale part of os temporale,take down the expanded bone petal using the skull drill,incise the dura mater,eliminate the haematoma and the broken brain tissue.At the same time get rid of the bone patal to reduce the pressure,soak the bone petal in 55% ethyl alcohol bottle and seal by the low temperature refrigeration.Results This group of 46 patients treated by the surgery survive 36 patients,the good 28 patients,the moderate disabled 6 patients,the heavy disabled 2 patients,died 10 patients.Conclusion 46 patients of heavy craniocerebral trauma of frontal and temporal part used the improving surgery method to expand into the road dura mater forming technique treatment,survived 36 patients,has obtained the good effect. ......