中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2014年
17期
2601-2603
,共3页
颅脑损伤%神经外科手术%治疗结果%预后
顱腦損傷%神經外科手術%治療結果%預後
로뇌손상%신경외과수술%치료결과%예후
Craniocerebral trauma%Laser surgery%Treatment outcome%Prognosis
目的：比较扩大翼点入路术与传统手术治疗额颞对冲性颅脑损伤的疗效和预后，为临床治疗提供依据。方法采用回顾性研究，选择额颞对冲性颅脑损伤患者112例，根据手术方式分为扩大翼点入路术组58例（观察组）和传统手术组54例（对照组）。观察和评价两组术后GOS分级，比较术前和术后第1、3、6天颅内压及术后两组预后结果。结果观察组植物生存率为10．34％（6/58），低于对照组的27．78％（15/54）（χ2＝4．58，P＜0．05）；观察组中残率为29．31％（17/58），高于对照组的16．67％（9/54）（χ2＝4．20， P＜0．05）；观察组重度脑水肿为10．34％（6/58），低于对照组的20．37％（11/54）（χ2＝4．78，P＜0．05）；观察组硬膜下积液为12．07％（7/58），低于对照组的24．07％（13/54）（χ2＝3．96，P＜0．05）；观察组术后第1、3天颅内压分别为（302．18±17．33）mmH2O和（260．32±17．42）mmH2O，低于对照组的（371．24±18．40）mmH2O和（322．17±16．28）mmH2O（t＝7．53、5．39，均P＜0．05）。结论扩大翼点入路术能够充分清理创面，最大限度地清除血肿，止血较彻底，有利于脑功能的保护，对于提高患者的生存质量有重要临床价值。
目的：比較擴大翼點入路術與傳統手術治療額顳對遲性顱腦損傷的療效和預後，為臨床治療提供依據。方法採用迴顧性研究，選擇額顳對遲性顱腦損傷患者112例，根據手術方式分為擴大翼點入路術組58例（觀察組）和傳統手術組54例（對照組）。觀察和評價兩組術後GOS分級，比較術前和術後第1、3、6天顱內壓及術後兩組預後結果。結果觀察組植物生存率為10．34％（6/58），低于對照組的27．78％（15/54）（χ2＝4．58，P＜0．05）；觀察組中殘率為29．31％（17/58），高于對照組的16．67％（9/54）（χ2＝4．20， P＜0．05）；觀察組重度腦水腫為10．34％（6/58），低于對照組的20．37％（11/54）（χ2＝4．78，P＜0．05）；觀察組硬膜下積液為12．07％（7/58），低于對照組的24．07％（13/54）（χ2＝3．96，P＜0．05）；觀察組術後第1、3天顱內壓分彆為（302．18±17．33）mmH2O和（260．32±17．42）mmH2O，低于對照組的（371．24±18．40）mmH2O和（322．17±16．28）mmH2O（t＝7．53、5．39，均P＜0．05）。結論擴大翼點入路術能夠充分清理創麵，最大限度地清除血腫，止血較徹底，有利于腦功能的保護，對于提高患者的生存質量有重要臨床價值。
목적：비교확대익점입로술여전통수술치료액섭대충성로뇌손상적료효화예후，위림상치료제공의거。방법채용회고성연구，선택액섭대충성로뇌손상환자112례，근거수술방식분위확대익점입로술조58례（관찰조）화전통수술조54례（대조조）。관찰화평개량조술후GOS분급，비교술전화술후제1、3、6천로내압급술후량조예후결과。결과관찰조식물생존솔위10．34％（6/58），저우대조조적27．78％（15/54）（χ2＝4．58，P＜0．05）；관찰조중잔솔위29．31％（17/58），고우대조조적16．67％（9/54）（χ2＝4．20， P＜0．05）；관찰조중도뇌수종위10．34％（6/58），저우대조조적20．37％（11/54）（χ2＝4．78，P＜0．05）；관찰조경막하적액위12．07％（7/58），저우대조조적24．07％（13/54）（χ2＝3．96，P＜0．05）；관찰조술후제1、3천로내압분별위（302．18±17．33）mmH2O화（260．32±17．42）mmH2O，저우대조조적（371．24±18．40）mmH2O화（322．17±16．28）mmH2O（t＝7．53、5．39，균P＜0．05）。결론확대익점입로술능구충분청리창면，최대한도지청제혈종，지혈교철저，유리우뇌공능적보호，대우제고환자적생존질량유중요림상개치。
Objective To compare on therapeutic efficacy and prognosis evaluation of extended pterional approach operation with the traditional operation treatment for frontotemporal contrecoup craniocerebral injury , and provide the clinical basis for the treatment.Methods By retrospective study,112 patients with frontotemporal contrecoup craniocerebral injury were selected randomly .There was extended pterional approach operation group ( observation group,58 cases) and traditional operation treatment group (the control group,54 cases).We observed and evaluated indexes including of postoperative GOS grade assessment ,intracranial pressure measurement of 1,3,6 day preoperative and postoperative and the outcomes after operation of two groups .Results The plant survival rate of the observation group was 10.34%(6/58),lower than that of the control group 27.78%(15/54),the difference was significant (χ2 =4.58,P<0.05);The residual rate in the observation group was 29.31%(17/558),more than that of control group 16.67%(9/54),the difference was significant (χ2 =4.20,P<0.05);The severe brain edema of the observation group was 10.34%(6/58),lower than that of the control group 20.37%(11/54),the difference was significant (χ2 =4.78,P<0.05);Subdural effusion of the observation group was 12.07%(7/558),lower than that of the con-trol group 24.07%(13/54),the difference was significant(χ2 =3.96,P<0.05).The intracranial pressure of observa-tion group after 1 days and 3 days after operation were(302.18 ±17.33)mmH2O and (260.32 ±17.42)mmH2O,low-er than that of the control group was (371.24 ±18.40)mmH2O and (322.17 ±16.28)mmH2O,the difference was significant(t=7.53,5.39,all P<0.05).Conclusion Extended pterional approach could clean wound and hemato-ma fully,bleed thoroughly ,and be conducive to the protection of brain function .It is important for the clinical value to improve the quality of life of patients .
