[摘要]目的 探讨急性硬膜下血肿(ASDH)伴脑水肿的手术治疗方法与临床效果，为改善患者治疗预后提供依据。方法 选取2014年1月～2017年2月我院神经外科收治的符合病例选择标准的86例ASDH伴脑水肿患者作为研究对象，按照随机数字表法将其分为A组(行标准外伤大骨瓣开颅术)与B组(行常规骨瓣开颅术)，每组各43例。进行术后随访，观察两组患者的并发症发生情况，采用格拉斯哥预后评分系统(GOS)评价两组患者的治疗结局。结果 A组患者仅发生1例急性脑膨出，术后并发症发生率为2.33%，B组患者的并发症发生率为13.95%，两组患者的并发症发生率比较，差异有统计学意义(P<0.05)。A组患者的治疗结局优于B组，差异有统计学意义(P<0.05)。结论 对ASDH伴脑水肿患者，尽早实施标准外伤大骨瓣开颅术能够有效改善预后质量，降低并发症发生率，值得临床推广应用。

    [关键词]急性硬膜下血肿；脑水肿；标准外伤大骨瓣开颅术

    [中图分类号] R743 [文献标识码] A [文章编号] 1674-4721(2018)10(a)-0076-03

    [Abstract] Objective To explore the surgical treatment and clinical effect of acute subdural hematoma (ASDH) accompanied with cerebral edema so as to provide evidence for improving the patients′ prognosis. Methods Altogether 86 cases of ASDH accompanied with cerebral edema who were treated in Department of Neurosurgery of our hospital from January 2014 to February 2017 and qualified for case selection criteria were selected as subjects and divided into group A (standard large trauma craniotomy) and group B (conventional craniotomy) according to the random number table method ......