扩大翼点入路手术治疗额颞对冲性颅脑损伤的效果及预后的改善

The effect of extended pterional approach operation in treatment of frontotemporal contrecoup craniocerebral injury and the improvement of prognosis

目的分析额颞对冲性颅脑损伤(HI)行扩大翼点入路手术的价值与预后情况。方法选择2016年1月至2020年1月间来院治疗的132例HI患者。以随机法为基准,A组67例,手术入路选用扩大翼点法,B组65例,直接选择开颅手术。对比整体化疗效。结果A组的良好痊愈率为61.19%,高于B组的43.08%;A组的死亡率为2.99%,低于B组的15.38%,两组比较,差异有统计学意义(P<0.05)。A组的不良事件发生率为4.48%,低于B组的16.92%,两组比较,差异有统计学意义(P<0.05)。术后各个时间点,A组的颅内压值低于B组,两组比较,差异有统计学意义(P<0.05)。术后次日,A组的患者状态评分均高于B组(P<0.05)。结论为HI患者实行扩大翼点入路形式的手术治疗可改善预后,而且能够最大化减少不良事件,降低患者的颅内压,疗效理想。

Objective To analyze the value and prognosis of the extended pterional approach operation for frontotemporal contradictory craniocerebral injury(HI).Methods A total of 132 patients with HI(frontotemporal contrecoup)admitted in the hospital from January 2016 to January 2020 were selected for the study objects and were grouped according to the random method.The group A(67 cases)used the extended pterion operation approach,and the group B selected direct craniotomy.The overall efficacy was compared.Results The excellent cure rate of group A was 61.19%,which was higher than 43.08%of group B.The mortality rate of group A was 2.99%,which was lower than 15.38%of group B.The difference between the two groups was statistically significant(P<0.05).The probability of adverse events in group A was 4.48%,which was lower than 16.92%in group B.The difference between the two groups was statistically significant(P<0.05).At various time points after the operation,the intracranial pressure value of group A was lower than that of group B,and the difference between the two groups was statistically significant(P<0.05).On the next day after the operation,the patient status scores in group A were higher than those in group B(P<0.05).Conclusion Extended pterional approach operation for patients with HI can improve the prognosis,maximize the reduction of adverse events,and reduce the patient's intracranial pressure,which has an ideal effect.