扩大翼点入路术治疗额颞对冲性颅脑损伤的疗效及预后观察

Clinical Effect and Prognosis of Microsurgery through Modified Pterional-approach in the Treatment of Fronto-temporal Contrecoup Injury

目的:探讨扩大翼点入路术治疗额颞对冲性颅脑损伤的临床疗效及预后。方法:选取笔者所在医院收治的96例额颞对冲性颅脑损伤患者作为研究对象,采用随机数字表法将所选患者分为研究组和对照组,各48例,研究组采用扩大翼点入路术治疗,对照组采用传统手术入路治疗,综合比较两组患者术后GOS分级情况及预后指标的差异。结果:研究组恢复良好率高于对照组(P<0.05),植物生存率、死亡率分别为8.3%、18.8%,均显著低于对照组的25.0%、37.5%(P<0.05);研究组患者重度脑水肿、硬膜下积液等并发症发生率均低于对照组(P<0.05)。结论:扩大翼点入路术治疗额颞对冲性颅脑损伤疗效确切,可明显改善预后,值得临床推广使用。

Objective：To explore the clinical effect and prognosis of microsurgery through modified pterional-approach in the treatment of fronto-temporal contrecoup injury.Method：96 patients with fronto-temporal contrecoup injury admitted to our hospital were selected,they were divided into the study group and the control group by random number table method,48 cases in each group.The study group was treated by microsurgery through modified pterional-approach and the control group was treated by traditional fronto-temporal craniotomy.The GOS standard and prognostic index between two groups were comprehensively compared.Result：The rate of excellent of the study group was higher than that of the control group（P〈0.05）.The mortality rate and plant survival rate of the control group were 37.5%and 25.0%,and those in the study group were 18.8%and 8.3%,there were significantly differences（P〈0.05）.The patients with severe brain edema and subdural liquid of the study group were less than those of the control group（P〈0.05）. Conclusion：The microsurgery through the modified pterional-approach is an effective method of treating fronto-temporal contrecoup injury.It can improve the prognosis and is worth of clinical using.