摘要：
Objective To compare the effect between autologous fascia and artificial duramater in duramatral neoplas ty.Methods A total of 140 patients with hypertensive intracerebral hemorrhage who underwent craniotomy in Zhoukou Hospital of Traditional Chinese Medicine from February 2014 to May 2017 were selected.The patients were divided into observation group (n =90) and control group (n =50) according to dural repair method.The autologous fascia was used to repair dura mater in the observation group,and the artificial duramater was used to repair dura mater in the control group.The Glasgow Coma Scale (GCS) score,activity of daily living(ADL) and the incidence of postoperative complication were compared between the two groups.Results The eusemia rate of ADL in the observation group and the control group was 98.89％ (89/90) and 90％ (45/50) respectively at three months after operation,the eusemia rate of ADL in the observation group was significantly higher than that in the control group (x2 =6.191,P ＜ 0.05).There was no significant difference in GCS score between the two groups before operation (t =2.362,P ＞ 0.05),the GCS score at three months after operation were significantly higher than that before operation in the two groups (t =7.123,9.612;P ＜ 0.05),the GCS score in the observation group was significantly higher than that in the control group at three months after operation (t =5.710,P ＜ 0.05).The incidence of postoperative cerebrospinal leak,incision infection,cenencephalocele and epilepsy was 1.11％ (1/90),1.11％ (1/90),2.22％ (2/90) and 3.33％ (3/90) respectively in the observation group;and the incidence of postoperative cerebrospinal leak,incision infection,cenencephalocele and epilepsy was 10.00％ (5/50),8.00％ (4/50),12.00％ (6/50) and 14.00％ (7/50) respectively in the control group;the incidence of postoperative cerebrospinal leak,incision infection,cenencephalocele and epilepsy in the observation group was significantly lower than that in the control group (x2 =6.191,5.704,5.514,4.429;P ＜ 0.05).Conclusion The autologous fascia is easy to suture,and there is no rejection reaction.It can significantly improve the prognosis of patients and reduce the incidence of complications in duramatral neoplasty.%目的 比较自体筋膜与人工硬脑膜在硬脑膜修补术中的应用效果.方法 选取2014年2月至2017年5月于周口市中医院行开颅手术的高血压脑出血患者140例,根据硬脑膜修补方法分为观察组90例和对照组50例.观察组患者术中采用自体筋膜修补硬脑膜,对照组患者术中采用人工硬脑膜修补硬脑膜.对2组患者Glasgow昏迷量表(GCS)评分、日常生活活动(ADL)术及术后并发症发生率进行比较.结果 术后3个月,观察组和对照组患者ADL预后良好率分别为98.89％ (89/90)、90.00％(45/50),观察组患者ADL预后良好率显著高于对照组(x2=6.191,P＜0.05).术前2组患者GCS评分比较差异无统计学意义(t=2.362,P＞0.05);2组患者术后3个月GCS评分均显著高于术前(t =7.123、9.612,P＜0.05);术后3个月,观察组患者GCS评分显著高于对照组(t=5.710,P＜0.05).观察组患者术后脑脊液漏、切口感染、脑膨出及癫痫发生率分别为1.11％ (1/90)、1.11％ (1/90)、2.22％ (2/90)、3.33％ (3/90),对照组患者术后脑脊液漏、切口感染、脑膨出及癫痫发生率分别为l0.00％(5/50)、8.00％ (4/50)、12.00％(6/50)、14.00％(7/50),观察组患者术后脑脊液漏、切口感染、脑膨出及癫痫发生率显著低于对照组(x2 =6.191、5.704、5.514、4.429,P＜0.05).结论 在开颅手术中应用自体筋膜修补硬脑膜易于缝合,无排异反应,能显著改善患者预后,降低并发症发生率.
