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目的：探讨重型颅脑损伤去骨瓣减压术的并发症发生原因。方法回顾性分析武警山东省总队医院神经外科2008年1月~2014年12月间经去骨瓣减压术治疗的261例患者的临床资料。结果135例出现并发症，占51.72%。其中术中脑膨出32例（12.26%）；再发血肿25例（9.58%）；术后脑梗死36例（13.79%）；骨窗区积液42例（16.09%），有两种以上并发症者占65%。结论伤情是并发症的主因，手术不及时和减压速度过快可加重或导致并发症的发生。“,”Objective To explore the causes of complications of decompressive craniectomy in severe craniocerebral injury. Methods A retrospective analysis was conducted on the data of 261 cases of decompressive craniectomy in severe craniocerebral injury in between January 2008 and December 2014. Results It revealed 135 cases with complications (51.72%), 32 cases with intraoperative encephalocele (12.26%), 25 cases with recurrent hematoma (9.58%), 36 cases with cerebral infarction after operation (13.79%), 42 cases with effusion in bone window (16.09%). In addition, 167 out of the 261 cases were found two or more types of complications (65%). Conclusion Injury severity is considered as the leading cause for complications. In addition, an untimely operation and an excessive decompression may also aggravate or lead to complications.