额颞叶脑内血肿并发脑疝术中额骨去留的疗效分析

摘要

Objective To compare the efficacy of removal with presevation of the frontal bone in standard large decompressive craniotomy for frontotemporal intracerebral hematoma complicated with brain hernia.Methods 73 patients with frontotemporal intracerebral hematoma complicated with cerebral hernia were randomly divided into control group (33 patients,removal of the temporal bone and the frontal bone) and study group (40 patients,removal of the temporal bone with presevation of the frontal bone).The decompression effect,prognosis,and patient satisfaction were compared between the two groups and the data were analyzed statistically.Results The study group was slightly superior to the control group in decompression efficacy and prognosis (85.0％ vs.84.8％ and 87.8％ vs.87.5％),with a no significant statistical difference (P＞ 0.05).The rate of patient satisfaction was higher in the study group than in the control group (92.50％ vs.81.82％).The medical costs were lower in the study group.Conclusions Removal of the temporal bone with presevation of the frontal bone in standard large decompressive craniotomy for frontotemporal intracerebral hematoma complicated with brain hernia is efficacious and less invasive and has better prognosis,fewer medical costs,and higher patient satisfaction degree.Thus it is worth popularizing in primary hospitals.%目的 比较标准外伤大骨瓣开颅术去除颞骨及额骨与去除颞骨保留额骨治疗额颞叶脑内血肿并发脑疝患者的效果.方法 选取我院收治的73例额颞叶脑内血肿并发脑疝患者,将其随机分为对照组33例和观察组40例;对照组采用标准大骨瓣开颅减压术(去除颞骨及额骨),观察组采用标准大骨瓣开颅减压术(去除颞骨保留额骨),对两组的减压效果、预后、住院满意度等进行比较,统计分析所得数据.结果 观察组术后减压有效率85.0％,预后有效率87.8％,略优于对照组的84.8％、87.5％,差异无统计学意义(P＞0.05);但观察组住院患者满意度高于对照组(92.50％ vs.81.82％),费用低于对照组.结论 在额颞叶脑内血肿并发脑疝患者手术中,采用去除颞骨保留额骨的手术方法,疗效佳,预后好,后期治疗费用低廉,能有效减轻患者创伤和经济负担,提高住院患者满意度,值得在基层医院临床上推广.