经眉弓眶上锁孔入路治疗单侧额部硬膜外血肿(附54例报告)

Trans-supraorbital keyhole approach forunilateral frontal extradura hemorrhage

目的比较常规冠状开颅入路与经眉弓眶上锁孔入路治疗单侧额部硬膜外血肿的效果。方法选取新疆医科大学第一附属医院神经外科中心2013年3月~2016年3月收治的54例单侧额部硬膜外血肿患者作为研究对象,随机分为对照组和锁孔组,各27例。分别给予常规冠状开颅术与经眉弓眶上锁孔入路治疗,比较两组患者手术时间、术中出血量、住院天数、住院费用及预后效果。结果两组均无中残、重残及死亡患者,两组的良好率及轻残率比较差异无统计学意义(均P>0.05);锁孔组术中手术时间、术中出血量、住院天数、住院费用明显优于对照组,差异有统计学意义(均P<0.01)。结论经眉弓眶上锁孔入路治疗单侧额部硬膜外血肿,能够缩短手术时间,具有安全、失血少、简单、创伤小、术后恢复快等优点。

Objective To compare the effect of coronal approach craniotomy and Transsupraorbital keyhole approach craniotomy in treatment of unilateral frontal extradura hemorrhage.Methods 54 cases of patients with unilateral frontal extradura hemorrhage admitted and treated in our hospital from March 2013 to March 2016 were selected as the research objects and randomly divided into two groups with 27 cases in each,the control group were treated with coronal approach craniotomy,the experimental group were treated with Trans-supraorbital keyhole approach craniotomy,and the intraoperative blood loss,operation time,length of stay,Hospital costs and prognosis effect were compared between the two groups. Results There was no case with moderate disability,severe disability and death in the two groups,and there was no obvious difference in the good rate and mild disability between the two groups（ P〉0. 05）,the the intraoperative blood loss,operation time,length of stay,Hospital costs in the experimental group were obviously better than those in the control group,and the differences had statistical significance by comparison（ P〈0. 01）. Conclusion Trans-supraorbital keyhole approach craniotomy in treatment of unilateral frontal extradura hemorrhage can shorten operation time with the advantages of safety,less blood loss,simpleness,small trauma and rapid postoperative recovery.