两种手术入路治疗非对称性双额叶脑挫裂伤的疗效比较  

Comparison of the curative effect between two kinds operation approaches in the treatment of asymmetry brain bilateral frontal lobe contusion

作　　者：王永志[1] 钱令涛[1] 高志波[1] 高心保[1] 梁卫东[1] 宁亮[1] 李严[1] 

机构地区：[1]安徽省阜阳市人民医院神经外科,236004

出　　处：《蚌埠医学院学报》2016年第12期1570-1572,共3页Journal of Bengbu Medical College

基　　金：安徽省阜阳市卫生局科研基金资助项目(2009448)

摘　　要：目的：探讨两种手术入路治疗非对称性双额叶脑挫裂伤的临床疗效。方法：32例非对称性双额叶脑挫裂伤患者随机均分为观察组和对照组。对照组行冠状双额开颅,观察组行单侧额颞部开颅,比较2组患者手术操作时间、术中输血量、嗅神经功能损伤以及精神障碍情况,并于术后3个月采用格拉斯哥预后评分（GOS）评估患者预后。结果：观察组患者手术时间、术中输血量、术后嗅神经损伤及精神障碍人数均低于对照组（P〈0.05~P〈0.01）;2组均无死亡患者,GOS评分比较差异无统计学意义（P〉0.05）。结论：单侧开颅治疗非对称性双额叶脑挫裂伤具有手术时间短、失血少及神经功能损伤小等优点,在严格掌握手术适应证前提下值得临床应用。Objective： To investigate the clinical effects of two kinds of operation approaches in the treatment of asymmetry brain bilateral frontal lobe contusion. Methods： Thirty-two patients with asymmetry brain bilateral frontal contusion were randomly divided into the observation group and control group. The control group were treated with bilateral frontal craniotomy in coronal plane,and the observation group were treated with unilateral frontotemporal craniotomy. The operation time,intraoperative transfusion volume,olfactory nerve function injury and mental disorders between two groups were compared. The prognosis of all patients were assessed using the Glasgow Outcome Scale score after 3 months of operation. Results： The operation time and intraoperative transfusion volume,and number of patients with olfactory nerve function injury and mental disorders in observation group were lower than those in control group（ P〈0. 05 to P〈0. 01）. No death case was found during the following-up,and the difference of Glasgow Outcome Scale score between two groups was not statistically significant（ P〉0. 05）. Conclusions： Unilateral craniotomy in the treatment of asymmetry brain bilateral frontal lobe contusion is shorter operation time,less blood loss and nerve function injury,which is worthy of application under the strict surgical indications.

关 键 词：颅脑损伤 双额叶脑挫伤 开颅术 大脑镰切开 

分 类 号：R651.15[医药卫生—外科学]