目的介绍漂浮骨瓣下缘在重型颅脑损伤外减压术中的应用。方法对28例重型颅脑损伤术中让骨瓣下缘浮于骨窗上硬脑膜与骨膜之间,骨瓣上缘疏松固定。结果漂浮骨瓣下缘术后早期有外减压作用,待脑水肿消退后,骨瓣自动回复,后期骨瓣可达临床愈合。结论重型颅脑损伤术中出现颅内压增高时,漂浮骨瓣下缘术式具有自动减压作用,避免去骨瓣后因颅骨缺损行Ⅱ期人工颅骨修补以及因颅骨缺损而给病人造成的心理、生理和经济负担。 Objective To introduce the application of floating lower extremity flap in the decompression of severe traumatic brain injury. Methods 28 cases of severe craniocerebral injury during the operation so that the lower edge of the flap floating in the dural window between the dura and periosteum, loosely fixed upper edge of the bone flap. Results The lower edge of the floating flap had external decompression after the operation. After the brain edema subsided, the bone flap recovered automatically and the postoperation bone flap reached clinical healing. Conclusion When intracranial pressure is increased during operation of severe craniocerebral injury, the technique of decompression of the lower edge of the floating bone flap can avoid the debridement of the skull due to skull defects in the stage Ⅱ artificial skull repair and due to skull defects caused to the patient Psychological, physical and financial burden.