扩大翼点入路治疗外侧裂区脑挫裂伤合并硬膜下血肿35例临床分析  

Amplification of Pterional Approach in the Treatment of 35 Cases of the Lateral Fissure Contusion and Laceration of Brain Combined Subdural Hematoma

作　　者：高亚峰[1] 常奎[1] 张义彪[1] 徐敬斌[1] 

机构地区：[1]阜阳市第二人民医院神经外科,安徽236015

出　　处：《安徽卫生职业技术学院学报》2010年第2期38-39,共2页Journal of Anhui Health Vocational & Technical College

摘　　要：目的:探讨外侧裂区脑挫裂伤合并硬膜下血肿以扩大翼点入路手术治疗策略。方法:以Yasargil翼点入路为基础,据处理损伤病灶需要,适当向额颞顶区扩大,先于颞窝处钻第一个骨孔并"十"字形切开硬脑膜,清除部分硬膜下血肿,初步减压。尽量向下扩大骨窗,咬除蝶骨嵴和颞骨鳞部,使前中颅窝相通,形成以外侧裂为中心的更大减压空间。结果:35例大脑外侧裂区脑挫裂伤合并硬膜下血肿,行扩大翼点入路术治疗,术后6个月神经功能康复采用GOS评分法:Ⅴ级22例,Ⅳ级4例,Ⅲ级2例,Ⅰ级7例。结论:对于外侧裂区脑挫裂伤合并硬膜下血肿,选择扩大翼点入路手术治疗,处理损伤灶方便、迅速,手术时间短,减压充分有效,是一种较好的手术方法,应注意保护外侧裂血管。Objective： To explore the value of pterional approach amplification in the treatment of the lateral fissure contusion and laceration of brain combined subdural hematoma. Methods： Yasargil pterional approach, based on lesion in dealing with the need to expand towards the appropriate amount of temporal-parietal area, first in the temporal fossa drill the first hole, and a ＂＋＂-shaped dual incision, removal of some subdural hematoma, initial decompression. As far as possible down to expand the bone window, bite off sphenoidal crest and temporal squama, so that anterior cranial fossa and middle cranial fossa interlinked to form a center for the lateral fissure of a larger space for decompression. Results： To investigate the postoperative nervous function by GOS score method, 22 cases grade Ⅴ, 4 cases grade Ⅳ, 2 cases grade Ⅲ, 7 cases gradeⅠ. Conclusion： For the lateral fissure contusion and laceration of brain combined subdural hematoma, opting for expanded pterional surgical treatment is convenient, rapid, and the operative time is short, full and effective decompression. It＇s a good surgical technique, but the blood vessels of the lateral fissure should be protected.

关 键 词：扩大翼点入路 外侧裂区 脑挫裂伤 硬膜下血肿 

分 类 号：R651.1[医药卫生—外科学]