两种手术入路治疗双侧额叶脑挫裂伤伴颅内血肿的疗效观察

Observation on the Curative Effect of Two Different Kinds Operation Approach of Bilateral Frontal Brain Contusion and Laceration with Intracranial Hematoma

目的探讨两种手术入路方式治疗双侧额叶脑挫裂伤的临床疗效与价值。方法选择2011年5月至2013年5月我院收治的50例双侧额叶脑挫裂伴颅内血肿伤患者作为观察对象,随机分为观察组和对照组,每组各25例。观察组行单侧开颅术,对照组行双侧开颅术。比较两组患者手术操作及住院时间,神经功能损伤及回访患者意识恢复情况。结果观察组手术操作及住院时间显著低于对照组,嗅觉神经障碍、精神障碍明显少于对照组,差异均具有统计学意义(P<0.05);随访患者意识恢复情况,观察组GOS评分明显优于对照组(P<0.05)。结论单侧开颅术用于治疗双侧额叶脑挫伤伴颅内出血操作简单易行,安全系数高且手术时间短,血肿清除率高,能及时降低颅内压,将血肿对脑组织损伤降到最低,且不适症状少,能够明显改善患者生活能力,提高患者生活质量,值得临床推广应用。

Objective To investigate the clinical effect and value of two kinds of operation approach for the treatment of bilateral frontal brain contusion and laceration. Methods 50 bilateral frontal brain contusion and laceration with in- tracranial hematoma patients from May 2011 to May 2013 in our hospital were selected, and were divided randomly into ob- servation group and control group, each group had 25 cases. Observation group received eraniotomy, control group under- went bilateral craniotomy. Compared two groups of patients with operation and hospitalization time, nerve function injury and return visit to the patients recove^7 of consciousness. Results Operation and hospitalization time in observation group was significantly lower than control group, the olfactory nerve disorder, mental disorder were obviously less than that in control group, the differences were statistically significant （ P 〈 0. 05 ） , follow - up of patients with recovery of conscious- ness, the GOS score in observation group was significantly better than control group （ P 〈 0. 05 ）. Conclusion Unilateral craniotnmy for the treatment of bilateral frontal brain contusion with intracranial hemorrhage is simple, high safety coeffi- cient and short operation time, hematoma clearance rate, to reduce intraeranial pressure, the hematoma of brain damage to a minimum, and discomfort, can significantly improve patients life ability, improve the quality of life patients, is worthy of clinical application.