CAJ | 학술논문

目的：探讨外伤性中央型脑疝患者手术治疗方式。方法回顾性分析2006年1月至2012年1月60例外伤性中央型脑疝患者的临床资料，观察组30例应用单侧骨窗开颅大脑镰切开手术治疗，对照组30例应用双侧骨瓣开颅手术治疗，比较两组患者手术时间、术中输血量、住院时间、术后3个月精神障碍和语言障碍的发生率，并于术后6个月比较两组患者临床疗效。结果观察组手术时间、术中输血量及住院时间均少于对照组，术后3个月精神障碍和语言障碍的发生率均低于对照组，差异均有统计学意义；术后6个月观察组预后良好22例（73.3%），对照组17例（50.6%）（χ2=1.1422，P=0.2790），差异无统计学意义。结论单侧骨窗开颅大脑镰切开治疗外伤性中央型脑疝创伤小、疗效显著，能最大程度保留额叶功能，可作为外伤性中央型脑疝优选的手术方案。
목적：탐토외상성중앙형뇌산환자수술치료방식。방법회고성분석2006년1월지2012년1월60예외상성중앙형뇌산환자적림상자료，관찰조30례응용단측골창개로대뇌렴절개수술치료，대조조30례응용쌍측골판개로수술치료，비교량조환자수술시간、술중수혈량、주원시간、술후3개월정신장애화어언장애적발생솔，병우술후6개월비교량조환자림상료효。결과관찰조수술시간、술중수혈량급주원시간균소우대조조，술후3개월정신장애화어언장애적발생솔균저우대조조，차이균유통계학의의；술후6개월관찰조예후량호22례（73.3%），대조조17례（50.6%）（χ2=1.1422，P=0.2790），차이무통계학의의。결론단측골창개로대뇌렴절개치료외상성중앙형뇌산창상소、료효현저，능최대정도보류액협공능，가작위외상성중앙형뇌산우선적수술방안。
Objective To investigate surgical approaches for patients with traumatic central brain herniation. Methods The clinical data of 60 patients with traumatic central cerebral hernia treated in our hospital from January,2006 to January,2012, were analyzed retrospectively.30 cases in the observation group were treated with the surgical approach of unilateral bone window craniotomy cerebral falx incision, and 30 cases in the control group were treated with the surgical approach of bilateral bone flap craniotomy, the operation time, blood transfusion volume during operatin, length of hospital stay, the rate of mental disorders and language obstacles 3 months after operation, and the clinical curative effect 6 months after operation were compared. Results The operation time,blood transfusion,length of hospital stay of the observation group were less than that of the control group,and the rate of mental disorders and language obstacles 3 months after operation were lower than that of the control group, the difference was statistically significant;22 cases (73.3%) were good recovery in the observation group and 20 cases (67.7%) in the control group 6 months after operation (χ2=2.4107,P=0.1205),there was no significant difference. Conclusion Is Treating with unilateral bone window craniotomy cerebral falx incision has minimalized trauma, significant effect and retention of frontal lobe function to the maximum extent for traumatic central brain herniation n, making it the preferred operation scheme on traumatic central brain herniation.