摘要
目的：比较颞肌下骨瓣开颅与传统大骨瓣开颅两种手术方式在治疗高血压脑出血早期脑疝患者的效果。方法将2011年1月至2015年1月在济宁医学院附属湖西医院收治的高血压脑出血早期脑疝患者64例按随机数字表法分为观察组（32例）和对照组（32例）。观察组给予颞肌下骨瓣开颅术，对照组给予传统大骨瓣开颅术。比较两组患者术后3个月内病死率及住院期间并发症发生率，术后6个月按GOS评分进行预后评估。结果观察组术后3个月病死率为9.4％（3／32），对照组为12.5％（4／32），两组比较差异无统计学意义[χ2＝0.00（校正），P＞0.05]。住院期间观察组7例患者出现严重并发症，发生率为21.9％（7／32）；对照组为16例，发生率为50.0％（16／32），两组比较差异有统计学意义（χ2＝5.50，P＜0.05）。术后6个月观察组患者恢复良好7例，中残8例，优良率46.9％（15／32）；对照组恢复良好4例，中残3例，优良率21.9％（7／32），两组比较差异有统计学意义（χ2＝4.27，P＜0.05）。结论对于高血压基底节区脑出血早期脑疝患者，颞肌下骨瓣开颅血肿清除术同样能有效解除脑疝，且较传统大骨瓣开颅能明显降低并发症发生率，改善患者预后。
Objective To explore the therapeutic effects of two kinds of operation mode of inferior temporal muscle bone flap craniotomy and traditional big bone flap craniotomy in treatment of hypertensive cerebral hemorrhage patients with early cerebral hernia.Methods Sixty.four cases patients of hypertensive cerebral hemorrhage with early cerebral hernia,treated in Huxi Hospital Affiliated to Jining Medical College from January 2011 to January 2015 were randomly divided into observation group （ 32 patients underwent temporal muscle bone flap craniotomy） and control group （ 32 patients underwent traditional big bone flap craniotomy）.The incidence rate of complications,mortality within 3 months,the excellent rate of GOS score on 6 months after the onset were compared.Results The mortality rate of 3 months after operation in the observation group was 9.4%（ 3/32） ,in the control group was 12.5%（ 4/32） ,the difference between the two groups was not significant （χ2=0.00（correction）,P〉0.05））.There were 7 cases had severe complications in the observation group,the incidence rate was 21.9%（ 7/32 ）;there were 16 patients had serious complications in control group, the incidence rate was 50%（ 16/32） ,the difference was statistically significant between the two groups（χ2=5.50,P〈0.05）.There were 7 cases recovered well,8 cases were residual,the excellent rate of GOS score was 46.9%（ 15/32） in the observation group;there were 4 cases recovered well,3 cases were residual,the excellent rate of GOS score 21.9%（ 7/32） in the control group,the difference was statistically significant（χ2=4.27,P〈0.05）.Conclusion For patients with hypertensive cerebral hemorrhage in basal ganglia region in the early stage of cerebral hernia,temporal muscle bone flap craniotomy hematoma removal can also effectively relieve the hernia, compared with traditional big bone flap craniotomy, can significantly reduce the incidence of complications, improve the prognosis of the patients.
出处
《中国综合临床》
2016年第8期701-703,共3页
Clinical Medicine of China
关键词
高血压
脑出血
脑疝
颞肌下骨瓣开颅术
Hypertention
Cerebral hemorrhage
Cerebral hernia
Inferior temporal muscle bone flap
