扩大翼点入路治疗重型颅脑损伤52例分析

Analysis of pterional approach amplitication in the treatment of sereve head injury

目的探讨基层医院应用扩大翼点入路治疗重型颅脑损伤的临床价值。方法52例重型颅脑损伤患者采用扩大翼点入路,30例采用常规开颅方法。扩大翼点入路即在翼点入路基础上扩大暴露范围,包括额底、颞底及额颞顶较大范围。扩大翼点入路结合硬膜扩大缝合,有时采用浮动骨瓣等方法。结果扩大翼点入路组治愈率高于常规组(P≤0.05);在减少脑组织膨出发生率(P≤0.05),降低再次手术率(P≤0.05)等方面也都优于常规开颅组。结论扩大翼点入路治疗重型颅脑损伤具有以下优点:提高治愈率,降低脑组织膨出发生率,降低再次手术率,值得基层医院推广。

Objective To explore the value of pterional approach amplification in the treatment of severe head injury in local hospitals. Methods A group of 52 cases of severe head injury were treated with improved craniotomy with pterional approach amplification, and another group of 30 cases were treated with conventional craniotomy. The base surfaces of middle cranial fossa, temporal lobe and forehead lobe were clearly exposed by the amplification of pterional approach. Meantime the patients were treated with dura mater relaxation suture and sometimes floating bone section. Results The therapy effect of the amplification group was better than that of the conventional group（P≤0.05）, decreased bulge rate was found in the amplification group （P≤0.05） and re-operation rate was lower than that of the conventional group （P≤0.05）. Conclusion Worth to extend in local hospitals ,the pterional approach amplification is an effective operative mode for treating severe head injury patients, with such advantages as higher cure rate , lower brain tissue bulge rate and re-operation rate.