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目的探讨单侧入路大脑镰切开治疗非对称性双额叶脑挫伤的临床效果。方法选取非对称性双额叶脑挫伤患者89例。按手术方式的不同,将患者分为观察组48例,行单侧入路大脑镰切开术;对照组41例,行双侧入路额叶冠状开颅术。观察两组手术时间、术中出血量及术后住院时间。术后3个月,以GOS评估患者预后;以额叶功能评定量表(FAB)评估患者额叶功能。结果观察组手术时间短,术中出血量少,术后住院时间短,与对照组比较,差异有统计学意义(P<0.05)。术后3个月,观察组恢复良好率高于对照组(54.2%vs.29.3%)(P<0.05);观察组死亡3例(6.2%),对照组死亡7例(17.1%),差异有统计学意义(P<0.05);观察组生存患者FAB评分高于对照组[(9.4±0.8)分vs.(7.2±1.0)分](P<0.05)。结论单侧入路大脑镰切开治疗非对称性脑挫伤创伤小、患者恢复快,可有效缩短手术时间,降低病死率,改善预后。
Objective To investigate the clinical effect of unilateral cerebral falx incision on asymmetric double frontal lobe contusion. Methods 89 cases of asymptomatic double frontal lobe contusion were selected. According to the different surgical methods, the patients were divided into observation group (n = 48), underwent unilateral cerebral falx surgery and control group (n = 41) underwent bilateral cranial cranial cranial surgery. The operation time, intraoperative blood loss and postoperative hospital stay were observed. At 3 months after surgery, the prognosis of patients was evaluated by GOS. The frontal lobe function was evaluated by frontal lobe function assessment scale (FAB). Results The observation group had shorter operation time, less intraoperative blood loss and shorter postoperative hospital stay, compared with the control group, the difference was statistically significant (P <0.05). At 3 months after operation, the recovery rate of the observation group was significantly higher than that of the control group (54.2% vs.29.3%, P <0.05). The death rate of the observation group was 3 cases (6.2%), and that of the control group was 7.1% (P <0.05). The score of FAB in survival group was higher than that in control group [(9.4 ± 0.8) vs (7.2 ± 1.0)] (P <0.05). Conclusion Unilateral approach for the treatment of cerebral falx disease treatment of asymmetric traumatic brain injury trauma, patients recover quickly, which can effectively shorten the operation time, reduce mortality and improve prognosis.