CAJ | 학술논문

目的了解冠状切口经额下入路患者术后眶上神经痛的发生率及临床特点,并探讨有效的术中神经保护策略和治疗方法.方法对照组为132例择期行常规冠状切口额下入路的神经外科患者,排除切口局部疼痛后记录眶上神经痛的发生时间、程度和性质,同时探讨药物和神经阻滞的治疗效果；神经保护组为27例采用改良皮下分离技术的冠状切口开颅患者,术后亦观察眶上神经痛的发生.结果对照组术后发生眶上神经痛13例(9.8％),除1例药物治疗有效外,其余12例经神经阻滞治疗后治愈；眶上神经痛出现于术后第3-4天,呈持续性伴阵发性加重,向同侧额部、顶部、颞部或眶周放散,查体眶上切迹处压痛明显.神经保护组无术后眶上神经痛发生.结论冠状切口经额下入路患者术后出现头痛时应注意鉴别眶上神经痛,一旦确诊应行以神经阻滞为主的综合治疗.同时改良的皮下分离技术可以有效防止术后眶上神经痛的发生.
목적 료해관상절구경액하입로환자술후광상신경통적발생솔급림상특점,병탐토유효적술중신경보호책략화치료방법.방법 대조조위132례택기행상규관상절구액하입로적신경외과환자,배제절구국부동통후기록광상신경통적발생시간、정도화성질,동시탐토약물화신경조체적치료효과；신경보호조위27례채용개량피하분리기술적관상절구개로환자,술후역관찰광상신경통적발생.결과 대조조술후발생광상신경통13례(9.8％),제1례약물치료유효외,기여12례경신경조체치료후치유；광상신경통출현우술후제3-4천,정지속성반진발성가중,향동측액부、정부、섭부혹광주방산,사체광상절적처압통명현.신경보호조무술후광상신경통발생.결론 관상절구경액하입로환자술후출현두통시응주의감별광상신경통,일단학진응행이신경조체위주적종합치료.동시개량적피하분리기술가이유효방지술후광상신경통적발생.
Objective To explore the clinical features and incidence of supraorbital neuralgia after subfrontal craniotomy,then study its therapeutic and intraoperative protection strategies.Methods Control group included 132 neurosurgical patients undergoing selective subfrontal craniotomy and the experimental group was consisted of patients operated with modified subcutaneous stratum dissection skill.The onset,severity,and character of the neuralgia were recorded. The therapeutic effects of medicine and neural blockade on neuralgia were observed. Results In control group, 13 (9.8％ )patients suffered from postoperative supraorbital neuralgia,it began 3 -4 days after subfrontal craniotomy.The headache could be persistent and became more serious intermittently and irradiated to frontal,parietal,temperal,and para -orbital region. Physical examination revealed homolateral tenderness of supraorbital notch. Severity of headache improved dramatically after neural blockade therapy.There was no supraorbital neuralgia occurred in the experimental group.Conclusions It is important to identify supraorbital neuralgia after subfrontal craniotomy.Neural blockade therapy gets excellent clinical result in treating post -craniotomy neuralgia,modified subcutaneous stratum dissection skill can reduce the occurrence of supraorbital neuralgia.