摘要
目的探讨超低位大骨瓣与常规骨瓣开颅颞肌下减压术治疗特重型颅脑创伤伴脑疝的效果对比。方法分析2013年1月～2016年1月我院神经外科收治的特重型颅脑创伤伴脑疝患者66例临床资料．依据手术治疗方式的不同进行分组，超低位大骨瓣组（超低位大骨瓣开颅颞肌下减压术治疗）33例和常规骨瓣组（采用常规骨瓣开颅颞肌下减压术治疗）33例。观察两组特重型颅脑创伤伴脑疝患者颅内压、生活质量评分、Synek分级、CAN分级、华杨分级情况。结果两组特重型颅脑创伤伴脑疝患者术前颅内压、生活质量评分、Synek分级、CAN分级、华杨分级比较，差异均无统计学意义（t=0．17、0．37、1．59、1．15、1．15，P〉0．05），超低位大骨瓣组术后颅内压（18．6±3．9）mmHg、Synek分级（2．8±0．4）级、CAN分级（1．5±0．2）级、华杨分级（1．8±0.3）级均低于常规骨瓣组的（23．5±4．0）mmHg、（3．3±0．3）级、（1．8±0.3）级、（2．2±0．4）级，生活质量（88．8±11．0）分高于常规骨瓣组的（75．4±12．3）分，差异均有统计学意义（t=5．04、4．66、5．74、4．78、4．60，P〈0．05）。结论超低位大骨瓣开颅颞肌下减压术治疗特重型颅脑创伤伴脑疝临床症状改善明显，效果良好。值得临床推广应用。
Objective To explore the effect comparison of ultra-low large craniotomy and conventional craniotomy decompression under temporalis in the treatment of extremely severe craniocerebral trauma accompanying with cerebral hernia.Methods From January 2013 to January 2016,clinical data from 66 patients extremely severe craniocerebral trauma with cerebral hernia admitted into our department were analyzed and evenly divided into ultra-low large craniotomy group （ultra-low large craniotomy decompression under temporalis,n =33） and conventional craniotomy （conventional craniotomy decompression under temporalis,n =33） according to different surgical methods.The intracranial pressure, quality of life score,Synek grading,CAN grading and Huayang grading in the two groups were observed.Results Before surgery,the intracranial pressure,quality of life score,Synek grading, CAN grading and Huayang grading in two groups was all not displayed statistical differences respectively （t=0.17,0.37,1.59,1.15 and 1.15,P〉0.05）.In the ultra-low large craniotomy group,the postoperative intracranial pressure,Syuek grading,CAN grading and Huayang grading was （18.6± 3.9） mmHg,（2.8±0.4） grades,（1.5±0.2） grades and （1.8±0.3） grades respectively,much lower than （23.5±4.0） mmHg,（3.3± 0.3） grades,（1.8±0.3） grades and （2.2±0.4） grades in the conventional craniotomy group.The quality of life score in the former group was （88.8±11.0） scores,higher than （75.4±12.3） scores in the latter one.The comparisons mentioned above were all displayed statistical differences （t=5.04,4.66,5.74,4.78 and 4.60,P〈0.05）.Conclusion Ultra-low large craniotomy decompression under temporalis can greatly improve clinical symptoms with good effect on treating extremely severe craniocerebral trauma accompanying with cerebral hernia,which is worthy of clinical promotion and application.
出处
《中国当代医药》
2016年第22期52-54,共3页
China Modern Medicine
关键词
特重型颅脑创伤
超低位大骨瓣
常规骨瓣
开颅颞肌下减压术
脑疝
Extremely severe craniocerebral trauma
Ultra-low large craniotomy
Conventional craniotomy
Decompressionunder temporalis
Cerebral hernia
