[1]陈 鹏,邵东传,王泽易,等.颞肌下与颞肌外颅骨修补对颅脑损伤预后的影响[J].医学信息,2021,34(12):142-144.[doi:10.3969/j.issn.1006-1959.2021.12.038]
　CHEN Peng,SHAO Dong-chuan,WANG Ze-yi,et al.The Influence of Subtemporal Muscle and External Skull Repair on the Prognosis of Craniocerebral Injury[J].Medical Information,2021,34(12):142-144.[doi:10.3969/j.issn.1006-1959.2021.12.038]
点击复制

颞肌下与颞肌外颅骨修补对颅脑损伤预后的影响()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
34卷
期数:
2021年12期
页码:
142-144
栏目:
临床研究
出版日期:
2021-06-15

文章信息/Info

Title:
The Influence of Subtemporal Muscle and External Skull Repair on the Prognosis of Craniocerebral Injury
文章编号:
1006-1959（2021）12-0142-03
作者:
陈 鹏; 邵东传; 王泽易; 等
（昆明市第一人民医院神经外科，云南 昆明 650034）
Author(s):
CHEN Peng; SHAO Dong-chuan; WANG Ze-yi; et al.
(Department of Neurosurgery,The First Hospital of Kunming,Kunming 650034,Yunnan,China)
关键词:
创伤性脑损伤; 颞肌; 颅骨修补
Keywords:
Traumatic brain injury; Temporal muscle; Skull repair
分类号:
R651.1+1
DOI:
10.3969/j.issn.1006-1959.2021.12.038
文献标志码:
A
摘要:
目的 探讨颞肌下与颞肌外钛网颅骨修补对创伤性颅脑损伤去骨瓣减压术后患者预后的影响。方法 选取2017年1月~2020年10月昆明市第一人民医院神经外科收治的60例外伤性颅内脑损伤去骨瓣减压术患者为研究对象，随机分成颞肌外组（n=28）和颞肌下组（n=32）。颞肌外组采用颞肌外颅骨修补术，颞肌下组采用颞肌下颅骨修补术。比较两组患者格拉斯哥预后评分（GOS）、简明精神状态量表（MMSE）评分、术后并发症发生率、住院时间、术中失血量。结果 术后3个月两组GOS及MMSE评分均高于术前，差异有统计学意义（P＜0.05），术后两组GOS及MMSE评分比较，差异无统计学意义（P＞0.05）；两组术中失血量、住院天数比较，差异无统计学意义（P＞0.05）；两组硬膜外血肿、积液及癫痫等并发症发生率比较，差异无统计学意义（P＞0.05）。结论 虽然颞肌下颅骨修补对患者术后并发症发生率及预后与颞肌外颅骨修补无区别，但颞肌下颅骨修补符合生理解剖复位，可避免咀嚼受限，卡压痛和外观异常，故颞肌下颅骨修补可能是一种可行的、更优的选择。
Abstract:
Objective To investigate the effect of skull repair with titanium mesh in the subtemporalis muscle and outside the temporal muscle on the prognosis of patients with traumatic brain injury after decompressive craniectomy.Methods 60 patients with traumatic intracranial brain injury undergoing decompressive craniectomy were selected from January 2017 to October 2020 in the Department of Neurosurgery of the First Hospital of Kunming.They were randomly divided into extratemporal muscle group (n=28) and inferior temporal muscle group (n=32).The extratemporal muscle group received an extratemporal skull repair, and the inferior temporal muscle group received an inferior temporalis skull repair.The Glasgow Outcome Score (GOS),Concise Mental State Scale (MMSE) score, postoperative complications, length of hospital stay, and intraoperative blood loss were compared between the two groups.Results The GOS and MMSE scores of the two groups were higher than those before the operation 3 months after operation,the difference was statistically significant (P＜0.05).There was no significant difference in GOS and MMSE scores between the two groups after surgery (P＞0.05);There was no statistically significant difference in blood loss and hospitalization days between the two groups (P＞0.05);There was no significant difference in the incidence of complications such as epidural hematoma, effusion and epilepsy between the two groups (P＞0.05).Conclusion Although the inferior temporal muscle skull repair has no difference in the incidence of postoperative complications and prognosis of patients with the external temporal skull repair,However, the repair of the skull under the temporalis muscle conforms to the physiological anatomical reduction, which can avoid restricted chewing, tenderness and abnormal appearance. Therefore, the repair of the skull under the temporalis muscle may be a feasible and better choice.

参考文献/References:

[1]Malcolm JG,Rindler RS,Chu JK,et al.Early Cranioplasty is Associated with Greater Neurological Improvement:A Systematic Review and Meta-Analysis[J].Neurosurgery,2018,82(3):278-288. [2]De Cola MC,Corallo F,Pria D,et al.Timing for cranioplasty to improve neurological outcome:A systematic review[J].Brain Behav,2018,8(11):e01106. [3]曾杰,孔德斌,李建华,等.颞肌外和颞肌下颅骨修补术治疗颅骨缺损患者的临床效果对比[J].医疗装备,2018,31(14):124-125. [4]Shibahashi K,Hoda H,Takasu Y,et al.Cranioplasty Outcomes and Analysis of the Factors Influencing Surgical Site Infection:A Retrospective Review of More than 10 Years of Institutional Experience[J].World Neurosurg,2017(101):20-25. [5]Ashayeri KM,Jackson E,Huang J,et al.Syndrome of the Trephined:A Systematic Review[J].Neurosurgery,2016,79(4):525-534. [6]Worm PV,Finger G,Ludwig do Nascimento T,et al.The impact of cranioplasty on the patients’quality of life[J].J Craniomaxillofac Surg,2019,47(5):715-719. [7]江辉,杨佳宁,凡徐.颞肌外和颞肌下颅骨修补术疗效分析[J].浙江创伤外科,2017,22(1):25-27. [8]李汉城,邱平华,谢乐辉,等.颞肌外和颞肌下钛网修补术治疗去骨瓣减压术后颅骨缺损患者的效果对比[J].中国医学创新,2019,16(11):5-8. [9]秦德广,黄文勇,杨灵,等.颞肌下与颞肌外两种术式修补额颞顶部颅骨缺损的远期效果比较[J].广东医学,2015,36(10):1548-1551. [10]Singh S,Singh R,Jain K,et al.Cranioplasty following decompressive craniectomy-Analysis of complication rates and neurological outcomes:A single center study[J].Surg Neurol Int,2019(10):142. [11]Spencer R,Manivannan S,Sharouf F,et al.Risk factors for the development of seizures after cranioplasty in patients that sustained traumatic brain injury:A systematic review[J].Seizure,2019(69):11-16. [12]江耿思,修俊刚,王振宁,等.颞肌外和颞肌下颅骨修补术疗效分析[J].中华神经创伤外科电子杂志,2015,1(4):12-15. [13]宁锦龙,黄剑峰,易椿均,等.颞肌下和颞肌外两种颅骨修补术式的临床疗效对比[J].中国临床神经外科杂志,2013,18(1):39-41. [14]叶宏权,魏大伟,谢峥,等.颞肌外钛网修补颅骨缺损48例临床分析[J].中国基层医药,2020,27(17):2150-2153. [15]王宣之,徐善水,方兴根,等.数字化成形钛网颅骨修补术后术区出血危险因素分析[J].中国神经精神疾病杂志,2020,46(4):221-225. [16]薛志伟,何伟坚,刘海新.颞肌下钛网修补颅骨缺损[J].江西医药,2020,55(6):677-679.

更新日期/Last Update: 1900-01-01