双额颞部开颅一次成型去大骨瓣减压术治疗双额叶脑挫裂伤临床研究  

Clinical study of forming a double frontotemporal craniotomy and removing large decompressive craniectomy to treat dual frontal brain contusion

作　　者：邓光策[1] 王岳华[1] 姚兴军[1] 侯文仲[1] 曾敏敏[1] 关北漩 李国峰[1] 

机构地区：[1]广东清远市人民医院,清远511500

出　　处：《中国实用神经疾病杂志》2015年第7期3-5,共3页Chinese Journal of Practical Nervous Diseases

基　　金：清远市科技计划项目(编号:2013B038)

摘　　要：目的探讨双额颞部开颅一次成型去大骨瓣减压术治疗双额叶脑挫裂伤的临床效果。方法采用随机单盲对照法,治疗组在手术时整块去除骨瓣、结扎矢状窦并完全剪开大脑镰,对照组采用常规保留骨桥但不剪开大脑镰,观察治疗效果。结果治疗组恢复良好23例,中度残疾13例,重度残疾2例,植物生存3例,死亡6例;对照组恢复良好15例,中度残疾10例,重度残疾7例,植物生存6例,死亡8例,治疗组明显优于对照组(P<0.05),且对中重度患者短期临床效果显著(P<0.01)。结论该术式治疗双额叶脑挫裂伤患者症状的临床疗效肯定,安全且并发症少。Objective To investigate the clinical effectiveness of forming a double frontotemporal craniotomy and removing large decompressive craniectomy to treat dual frontal brain contusion.Methods A randomized single‐blind controlled method was used. Treatment group （TG ,n=47） removed the whole craniectomy ,ligated the superior sagittal sinus and cut the whole falx.Control group （CG ,n=46） conventionally retained osteopontin and did not cut falx. The treatment efficacies of the two groups were observed.Results In TG ,23 cases were good recovery ,13 cases were moderate disability ,2 cases were severe disability ,3 cases were persistent vegetative ,6 cases were deaths;in CG ,15 cases were good recovery ,10 cases were moderate disability ,7 cases were severe disability ,6 cases were persistent vegetative ,8 cases were deaths. These were significantly bet‐ter in TG than CG （P〈0.05）. Especially ,it was significant better for clinical effect in the moderate to severe patients with short‐term treatment in TG than that of CG （ P 〈 0.01 ） . Conclusion T his is an affirmation and security surgical treatment for the patients with dual frontal lobe contusion symptoms ,and it also has fewer complications.

关 键 词：双额叶脑挫裂伤 双额颞部开颅 去大骨瓣减压术 

分 类 号：R651.15[医药卫生—外科学]