摘要
目的:探讨改良头皮拉钩在神经外科眶上外侧入路开颅前循环动脉瘤夹闭术中的应用价值。方法:纳入2019年1月到2020年4月首都医科大学附属北京天坛医院神经外科脑血管病专业组和北京大学国际医院神经外科眶上外侧入路开颅前循环动脉瘤夹闭术患者32例,研究对象选用随机数字表法分为传统头皮拉钩组和改良头皮拉钩组,每组16例。比较两组之间术中调整拉钩次数、切口的长度、术后头皮缺血坏死情况、术后7 d切口愈合等级、术后神经外科术者对头皮拉钩的满意度评分及患者对切口的满意度评分。结果:改良头皮拉钩组术中调整拉钩的次数显著小于传统头皮拉钩组[(10.1±2.2)次比(14.2±3.6)次,P<0.05],切口的长度也显著短于传统头皮拉钩组[(10.1±1.0)cm比(13.9±0.9)cm,P<0.05],术后神经外科术者对改良头皮拉钩的综合表现满意度也显著高于传统头皮拉钩组[(8.1±0.9)分比(6.0±0.9)分,P<0.05]。改良头皮拉钩组的术后头皮缺血坏死率、术后7 d切口愈合等级与传统拉钩组无明显区别(P>0.05)。结论:改良头皮拉钩在同等充分暴露颅内动脉瘤眶上外侧入路术野的情况下,手术切口更小,改良头皮拉钩可以减少术中调整拉钩的次数,节省手术时间消耗,优于传统头皮拉钩组。
Objective To investigate the application of a modified scalp retractor in the craniotomy for intracranial aneurysms withlateral supraorbital approach.Methods From January 2019 to April 2020,a total of 32 patients with anterior circulation aneurysms clipping by superior lateral orbital approach were selected from Beijing Tiantan Hospital and Peking University International Hospital.The subjects were randomly divided into the traditional scalp retractor group and the modified scalp retractor group utilizing a random number table,with 16 patients in each group.The number of intraoperative retractor adjustment,incision length,postoperative scalp necrosis rate,postoperative wound healing grade,postoperative neurosurgical satisfaction score and patients′satisfaction score for incision were compared between the two groups.Results The number of retractor adjustment in the modified scalp retractors group was significantly less than that in the traditional scalp retractor group(10.1±2.2 vs 14.2±3.6,P<0.05).Incision length was also significantly shorter than that of the conventional scalp retractor group((10.1±1.0)cm vs(13.9±0.9)cm,P<0.05).Neurosurgeons were significantly more satisfied with modified scalp retractors than the traditional scalp retractors(8.1±0.9 vs 6.0±0.9,P<0.05).There was no significant difference in postoperative scalp necrosis rate between two groups(P>0.05).Conclusion The modified scalp retractor group is superior to the traditional scalp retractor group in the craniotomy for intracranial aneurysms with later supraorbital approach,with shorter in cision,less retractor adjustment and shorter surgical time.
作者
叶迅
葛培聪
马力
陈玉
段然
谭存鑫
陈晓霖
王昊
赵元立
孟小娟
Ye Xun;Ge Peicong;Ma Li;Chen Yu;Duan Ran;Tan Cunxin;Chen Xiaolin;Wang Hao;Zhao Yuanli;Meng Xiaojuan(Department of Neurosurgery,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;Department of Neurosurgery,Peking University International Hospital,Beijing 102206,China;Department of Operating Room,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2020年第31期2467-2469,共3页
National Medical Journal of China
关键词
颅内动脉瘤
神经外科
改良头皮拉钩
脑血管病
Intracranial aneurysm
Neurosurgery
Modified scalp retractor
Cerebrovascular disease
