单、双侧开颅手术治疗额叶脑挫裂伤伴颅内血肿的效果比较

Comparison of effects of unilateral and bilateral craniotomy in the treatment of frontal lobe brain contusion and laceration complicated with intracranial hematoma

目的比较单、双侧开颅手术治疗额叶脑挫裂伤伴颅内血肿的效果。方法选取2018年1月至2020年12月我院诊治的50例额叶脑挫裂伤伴颅内血肿患者作为研究对象,根据手术方式不同将其分为对照组(双侧开颅手术治疗)与观察组(单侧开颅手术治疗),各25例。比较两组的临床指标、GOS评分优良率、术前及术后3 d、2周血清NSE、S100β蛋白水平。结果观察组的手术时间、住院时间短于对照组,平均输血量少于对照组,差异具有统计学意义(P<0.05)。观察组的GOS评分优良率为84.00%,高于对照组的56.00%,差异具有统计学意义(P<0.05)。术后2周,观察组的血清NSE、S100β蛋白水平均低于对照组,差异具有统计学意义(P<0.05)。结论单侧开颅手术治疗额叶脑挫裂伤伴颅内血肿患者,能获得较良好的治疗效果,可缩短患者的住院时间,有助于促进患者康复,值得临床推广应用。

Objective To compare the effects of unilateral and bilateral craniotomy in the treatment of frontal lobe brain contusion and laceration with intracranial hematoma.Methods A total of 50 patients with frontal lobe brain contusion and laceration complicated with intracranial hematoma treated in our hospital from January 2018 to December 2020 were selected as the research objects.According to different operation methods,the patients were divided into control group(bilateral craniotomy treatment)and observation group(unilateral craniotomy treatment),with 25 cases in each group.The clinical indexes,excellent and good rate of GOS score,the levels of serum NSE and S100βprotein before operation and on3 d,2 weeks after operation were compared between the two groups.Results The operation time and hospital stay in the observation group were shorter than those in the control group,the average amount of blood transfusion was less than that in the control group,and the differences were statistically significant(P<0.05).The excellent and good rate of GOS score in the observation group was 84.00%,which was higher than 56.00%in the control group,and the difference was statistically significant(P<0.05).Two weeks after operation,the levels of serum NSE and S100βprotein in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Unilateral craniotomy in the treatment of frontal lobe brain contusion and laceration complicated with intracranial hematoma can obtain a better therapeutic effect,shorten the hospital stay,and help to promote the rehabilitation of patients,which is worthy of clinical promotion and application.