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目的探讨单侧与双侧开颅术治疗双侧额叶脑挫裂伤伴颅内血肿的临床疗效。方法 73例双侧额叶脑挫裂伤伴颅内血肿患者按手术入路方式分为单侧组(32例)和双侧组(41例)。单侧组给予单侧开颅术,双侧组给予双侧开颅术。比较两组患者手术时间、住院时间、嗅觉障碍、精神障碍发生率等,并随访3个月,比较两组格拉斯哥(GOS)评分优良率。结果与双侧组相比,单侧组手术时间、住院时间缩短,嗅觉障碍和精神障碍发生率降低,差异均有统计学意义(P<0.05)。术后3个月,单侧组GOS评分优良率为87.5%,明显高于双侧组63.4%,差异有统计学意义(P<0.05)。结论单侧开颅术是双侧额叶脑挫裂伤伴颅内血肿安全有效的手术治疗方式,能够显著缩短手术时间、住院时间,降低术后嗅觉障碍、精神障碍发生率,并显著改善预后,疗效优于双侧开颅术,临床上值得进一步研究和推广。
Objective To investigate the clinical efficacy of unilateral and bilateral craniotomy in the treatment of bilateral frontal lobe contusion and intracranial hematoma. Methods A total of 73 patients with bilateral frontal lobe contusion and intracranial hematomas were divided into two groups according to the surgical approach: unilateral group (32 cases) and bilateral group (41 cases). Unilateral craniotomy was given on one side and bilateral craniotomy was given on both sides. The operation time, hospitalization time, olfactory dysfunction and the incidence of mental disorders in the two groups were compared and followed up for 3 months. The excellent and good rates of GOS scores were compared between the two groups. Results Compared with bilateral group, the operation time, hospitalization time, olfactory dysfunction and mental disorder in unilateral group decreased significantly (P <0.05). At 3 months after operation, the excellent and good rate of GOS score was 87.5% in unilateral group, which was significantly higher than that in bilateral group (63.4%), the difference was statistically significant (P <0.05). Conclusion Unilateral craniotomy is a safe and effective surgical treatment of bilateral frontal lobe contusion and intracranial hematoma, which can significantly shorten the operation time and hospital stay, reduce the incidence of postoperative olfactory dysfunction and mental disorders, and significantly improve the prognosis , Curative effect is better than bilateral craniotomy, clinical further worthy of further study and promotion.