两种皮瓣分离方法在标准外伤大骨瓣减压术中的应用比较  

Comparison of two flap dissection methods in the standard large decompression craniotomy

作　　者：吕一帆[1] 姚晓腾[2] 荆国杰[2] 李王安[2] 谢乙团[2] 林才[2] 刘克君[2] 李毅毅[2] 曾春生[2] 

机构地区：[1]广东医学院,湛江524000 [2]广东惠州市第一人民医院神经外科,惠州516000

出　　处：《中国实用神经疾病杂志》2012年第23期7-10,共4页Chinese Journal of Practical Nervous Diseases

摘　　要：目的比较单层皮瓣法与双层皮瓣法在标准外伤大骨瓣减压术中的应用效果。方法将43例符合标准并拟行标准外伤大骨瓣减压术的患者随机分为2组:单层皮瓣组20例,双层皮瓣组23例。结果 2组患者年龄、性别构成、术前颞肌体积和术中去除骨瓣面积差异无统计学意义,具有可比性。单层皮瓣组皮瓣分离时间(25.30±3.39)min,较双层皮瓣组(31.22±3.61)min明显缩短,术后晚期颞肌萎缩程度(6.81±1.61)cm3较双层皮瓣组(8.59±2.06)cm3轻,差异均有统计学意义(P<0.05);双层皮瓣组骨瓣成型时间(30.00±2.51)min,较单层皮瓣组(41.22±3.61)min明显缩短,开颅术总时间(61.22±3.38)min,较单层皮瓣组(67.2±4.25)min明显减少,术后早期颞肌水肿程度(7.87±1.79)cm3,明显较单层皮瓣组(17.37±4.90)cm3轻,差异均有统计学意义(P<0.05);2组患者面神经额支损伤发生率差异无统计学意义(P>0.05)。结论两种方法各有优势,单层皮瓣法皮瓣分离时间较短,术后早期颞肌水肿程度较轻;双层皮瓣组开颅总时间明显缩短,对颞肌直接损伤小,术后颞肌萎缩程度轻;两种方法在面神经额支保护方面无明显差异。Objective To compare the effect of monolayer flap method with double layer flap in 43 cases of standard large decompression craniotomy.Methods Forty-three patients met the criteria and underwent standard large decompression craniotomy,were randomly divided into two groups： monolayer flap group（20 cases） and double flap group（23 cases）.Results Patients＇ age,sex,preoperative temporal muscle volume and the surgical bone flap area had no significant difference.In monolayer flap group,surgical time of flap dissection was（25.30±3.39） minutes,which was significantly shorter compared with the double-flap group（31.22±3.61） minutes,temporal muscle atrophy after craniotomy（6.81±1.61） cm3 was lighter compared to the double-flap group（8.59±2.06） cm3,the differences were statistically significant（P〈0.05）.The time of bone flap dissection in double flap group was（30.00±2.51） minutes,which was significantly shorter compared to the single layer flap group（41.22±3.61） minutes,and the time of craniotomy was（61.22±3.38） minutes,which was less than monolayer flap group（67.2±4.25） minutes,temporal muscle edema（7.87±1.79） cm3 was significantly lighter compared to single-layer flap（17.37±4.90） cm3.The facial nerve injury incidence in two groups of patients with frontal branch had no significant difference（P〈0.05）.Conclusion Both methods have their advantages,the time of flap dissection in monolayer flap group is less and temporal muscle edema is lighter than double layer flap,but the time of craniotomy is longer,and temporal muscle atrophy degree is severity in double layer flap group.There is no significant difference between the two groups in the protection of the frontal branch of facial nerve.

关 键 词：皮瓣分离方法 标准外伤大骨瓣减压术 单层皮瓣法 双层皮瓣法 

分 类 号：R651.11[医药卫生—外科学]