大骨瓣开颅术与颞部直切口小骨窗锁孔开颅术治疗基底节出血的效果比较  

Comparison on efficacy of craniotomy with a large bone flap versus craniotomy with a small bone window locking hole in a straight temporal incision on patients with basal ganglia haemorrhage

作　　者：黄晓峰 杨晋生[2] 王俊善 Huang Xiaofeng;Yang Jinsheng;Wang Junshan(Department of Neurosurgery,the Third People's Hospital of Luoyang,Luoyang 471000,China;Department of Neurosurgery,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China)

机构地区：[1]河南省洛阳市第三人民医院神经外科,471000 [2]河南科技大学第一附属医院神经外科,河南洛阳471000

出　　处：《临床医学》2023年第12期13-16,共4页Clinical Medicine

摘　　要：目的 比较大骨瓣开颅术与颞部直切口小骨窗锁孔开颅术治疗基底节出血的临床效果。方法 选取2018年6月至2022年6月洛阳市第三人民医院与河南科技大学第一附属医院收治的72例基底节出血患者为研究对象,根据术式差异分为两组。研究组41例采用颞部直切口小骨窗锁孔开颅治疗,对照组31例采用大骨瓣开颅术治疗。比较两组患者的临床疗效(手术时间、开颅时间、住院时间、清除血肿比例)、并发症发生率、炎性指标、神经功能。结果 研究组手术时间、开颅时间及住院时间均显著低于对照组,清除血肿比例显著高于对照组,差异有统计学意义(P<0.05)。研究组术后并发症发生率(29.3%)显著低于对照组(54.8%),差异有统计学意义(P<0.05)。术前两组炎性指标比较,差异未见统计学意义(P>0.05),术后两组炎性指标与本组术前比较均升高,且对照组高于研究组(P<0.05)。术前两组神经功能比较,差异未见统计学意义(P>0.05),术后两组神经功能与本组术前比较均有所改善,且研究组优于对照组(P<0.05)。结论 颞部直切口小骨窗锁孔开颅手术对基底节出血患者的疗效更佳,不仅可缩短手术及开颅时间,同时还可减轻术后炎性反应程度,降低术后并发症发生率,最终改善其预后。Objective To compare the efficacy of craniotomy with a large bone flap and craniotomy with a small bone window locking hole in a straight temporal incision on patients with basal ganglia haemorrhage. Methods Seventy-two patients with basal ganglia hemorrhage from June 2018 to June 2022 in the Third People's Hospital of Luoyang and the First Affiliated Hospital of Henan University of Science and Technology were selected and divided into two groups according to the difference in the operation. Among them, 41 patients in the study group were treated by craniotomy with a small bone window locking hole in a straight temporal incision, while 31 patients in the control group were treated by craniotomy with a large bone flap. The clinical efficacy(operation time craniotomy time, hospital stay, the percentage of hematoma removal), the incidence of complications, inflammatory indexes and neurological funcation were compared between the two group. Results The study group had a significantly lower operative time, craniotomy time and hospital stay compared with the control group, while the percentage of hematoma removal was significantly higher than that in the control group(P<0.05). The postoperative complication rate was significantly lower in the study group(29.3%) than that in the control group(54.8%)(P<0.05). There was no significant difference in the inflammatory indexes between the two groups before surgery(P>0.05), while the inflammatory indexes in the two groups after surgery were higher than those before surgery, and the inflammatory indexes in the control group were higher than those in the study group(P<0.05). There was no difference in neurological function between the two groups before surgery(P>0.05), while neurological function improved in both groups after surgery compared with those before surgery, and improved more significanthy in the study group(P<0.05).Conclusions The straight temporal incision with a small bony window and locked hole craniotomy is more effective in patients with basal ganglia haemorrhag

关 键 词：颞部直切口小骨窗锁孔开颅术 大骨瓣开颅术 基底节出血 

分 类 号：R651.15[医药卫生—外科学]