摘要
目的探讨耳后切口去骨瓣减压术治疗大面积脑梗死的临床疗效。方法回顾性分析45例大面积脑梗死患者临床资料,根据去骨瓣减压切口分为标准大骨瓣组25例和耳后切口组20例。标准大骨瓣组采用常规切口。耳后切口组采取仰卧位,手术侧肩下垫高,头偏对侧位约60°,切口起自外耳道后4 cm、颧弓-枕外隆凸连线上1 cm,绕过顶结节后沿中线向前至前发迹。分析去骨瓣减压范围、颞浅动脉损伤率、手术时间、手术出血量、切口不良愈合率、切口感染率、术后3个月预后良好率等。结果耳后切口的骨瓣减压面积较标准大骨瓣切口的骨瓣减压面积显著增大(149.67 cm^(2)±8.20 cm^(2) vs.109.77 cm^(2)±12.98 cm^(2),P<0.001),耳后切口组发生颞浅动脉损伤较标准大骨瓣组的概率更低(0例vs.21例,P<0.001),但两组的手术时间、手术出血量、切口不良愈合率、切口感染率、术后3个月预后良好率无统计学差异(P>0.05)。结论耳后切口去骨瓣减压术可扩大去骨瓣减压范围,减少颞浅动脉损伤,在大面积脑梗死的手术治疗中有推广应用价值。
Objective To explore the curative effect of the retroauricular incision decompressive hemicraniectomy in treatment of patients with acute massive cerebral infarction by the experiment.Methods Forty-five patients with acute cerebral infarction who were admitted and treated in our hospital from Jun 2019 to Jun 2021 were selected.Twenty patients were treated with retroauricular incision decompressive hemicraniectomy and 25 patients were treated with the standard decompressive hemicraniectomy.Results The retroauricular incision decompressive hemicraniectomy had a larger decompressive window(149.67 cm^(2)±8.20 cm^(2) vs.109.77 cm^(2)±12.98 cm^(2),P<0.001)and less superficial temporal artery injury(0 vs.21,P<0.001)than standard decompressive hemicraniectomy after treatment.Conclusion The retroauricular incision decompressive hemicraniectomy is a safe and effective therapeutic method,so it is of great significance to promote the treatment scheme.
作者
夏家杰
姚斌
郑刚
宋大刚
孙陈军
陈锷峰
屠传建
XIA Jiajie;YAO Bin;ZHENG Gang;SONG Dagang;SUN Chenjun;CHEN Efeng;TU Ch-uanjian(Department of Neurosurgery,Shaoxing Central Hospital,Shaoxing 312000,China)
出处
《中国神经精神疾病杂志》
CAS
CSCD
北大核心
2022年第9期533-537,共5页
Chinese Journal of Nervous and Mental Diseases
基金
柯桥区2021年社会发展类经费自筹科技计划项目(编号:2021KZ25)。
关键词
大面积脑梗死
去骨瓣减压
切口
颞浅动脉
预后
Massive cerebral infarction
Decompressive hemicraniectomy
Incision
Superficial temporal artery
Prognosis
