小骨窗清除额叶脑挫裂伤基底节血肿治疗体会  

Experience of Removing Basal Ganglia Hematoma in Frontal Lobe Contusion and Laceration With Small Bone Window

作　　者：刘巍 LIU Wei(Department of Neurosurgery, Shijingshan Teaching Hospital of Capital Medical University, Beijing Shijingshan Hospital, Beijing 100000, China)

机构地区：[1]首都医科大学石景山教学医院北京市石景山医院神经外科

出　　处：《中国继续医学教育》2019年第17期86-88,共3页China Continuing Medical Education

摘　　要：目的评价小骨窗清除额叶脑挫裂伤及基底节区血肿手术的临床治疗体会。方法选取2017年1月-2019年1月本院接受治疗的额叶脑挫裂伤及基底节区血肿手术患者56例作为研究对象。采用分组方式对不同治疗方法效果进行评价,分组采用盲选法,组别包括对照组、观察组,每组患者均为28例。对照组采用常规手术方法进行治疗,观察组则使用小骨窗清除手术方法,将两组术后的效果进行对比。结果观察组患者的切口长度短于对照组,观察组患者的术中出血量、手术时间高于对照组,差异均具有统计学意义(P<0.05);观察组患者术后血肿完全清除率为85.74%,高于对照组,同时观察组患者残余血量10~30 mL比率为17.86%,低于对照组,差异均具有统计学意义(P<0.05);观察组术后的并发症发生率为10.71%,与对照组的35.71%进行对比,显著降低,差异具有统计学意义(P<0.05)。结论额叶脑挫裂伤及基底节区血肿借助小骨窗清除手术的方式,创口较小,手术的时间短,术后并发症少,不需要进行颅骨的修复,整体的治疗方法更加理想,病死率与致残率进一步下降,为患者术后康复创造更加理想的条件。Objective To evaluate the clinical experience of removing frontal lobe contusion and basal ganglia hematoma by small bone window.Methods 56 patients with frontal lobe contusion and laceration and basal ganglia hematoma treated in our hospital from January 2017 to January 2019 were selected as the study subjects. The effect of different treatment methods was evaluated by grouping method. The grouping method was blind selection. The grouping included control group and observation group,with 28 cases in each group. The control group was treated with routine operation, while the observation group was treated with small bone window clearance. The effect of the two groups was compared. Results The incision length of the observation group was shorter than that of the control group,and the bleeding volume and operation time of the observation group were higher than those of the control group, with statistical significance(P < 0.05).The complete clearance rate of hematoma in the observation group was 85.74%, which was higher than that in the control group. At the same time,the ratio of residual blood volume at 10~30 mL in the observation group was 17.86%, which was lower than that in the control group. The difference was statistically significant(P < 0.05). The incidence of complications in the observation group was 10.71%, which was significantly lower than that in the control group(35.71%), the difference was statistically significant(P < 0.05). Conclusion The frontal brain contusion and basal ganglia hematoma with small surgery to remove bone window way, small wound, short operation time, less postoperative complications, don’t need to carry on the repair of skull, the overall treatment method is more ideal, mortality and morbidity fall further, to create a more ideal conditions for patients with postoperative rehabilitation.

关 键 词：小骨窗 额叶脑挫裂伤 基底节区血肿 手术措施 临床效果 治疗体会 

分 类 号：R651[医药卫生—外科学]