【摘要】 目的:对比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。方法:选择2016年7月-2017年12月于本院行钛网修补术的去骨瓣减压术后颅骨缺损患者共78例,依照随机数字表法分为A组(行颞肌外钛网修补术)和B组(行颞肌下钛网修补术),各39例。比较分析两组手术相关指标以及术前术后神经功能缺损评分(NIHSS)、肢体运动功能(FMI)评分、术后随访1年预后相关指标和并发症发生情况。结果:A组出血量、手术用时、术后肿胀时间等手术指标和脑膜破损率均低于B组(P<0.05)。两组术后1年NIHSS评分均低于手术前,FMI评分均高于手术前,且术后B组NIHSS评分、FMI评分均优于A组(P<0.05)。两组术后1年格拉斯哥预后评分(GOS)均高于术前,且B组高于A组,B组患者对美观满意度高于A组(P<0.05)。随访1年内,B组患者并发症发生率低于A组(P<0.05)。结论:对去骨瓣减压术后颅骨缺损患者于颞肌外行钛网修补术术中损伤较小,但颞肌下钛网修补术则更利于改善患者神经、运动功能和预后,患者对美观的满意度较高,且并发症较少,其远期疗效优于颞肌外修补术。更多还原

【Abstract】 Objective:To compare the effect of titanium mesh repair outside and under temporal muscle on patients with skull defect after decompressive craniectomy.Method:78 patients with skull defect after decompressive craniectomy underwent titanium mesh repair in our hospital from July 2016 to December 2017 were divided into group A(extra-muscular titanium mesh repair)and group B(under-muscular titanium mesh repair)according to the random number table method,each with 39 cases.The surgical related indexes,preoperative and postoperative NIHSS score,FMI score,postoperative follow-up 1 year prognosis related indicators and complications of two groups were compared.Result:The indexes of hemorrhage,time of surgery and postoperative swelling time of group A were lower than those of group B(P<0.05).The NIHSS scores of the two groups were lower than those before operation and the FMI scores were higher than those before operation,and the indexes of group B were better than those of group A(P<0.05).The postoperative 1 year GOS score was higher than that of preoperative,and group B was higher than that in group A,the patients in group B had higher aesthetic satisfaction than that in group A(P<0.05).The incidence of complications in group B was lower than that in group A(P<0.05).Conclusion:In patients with skull defect after decompressive craniectomy,the injury of outside temporal muscle titanium mesh repair is small,however,under temporal muscle repair is more conducive to improving the patient’s nerve,motor function and patient prognosis,the patient’s aesthetic satisfaction is higher,and the complications are less,the long-term effect is better than the outside temporal muscle titanium mesh repair.更多还原