颅骨修补术后并发症的防治  

The prevention and cure of complications of skull coloboma prothesis

作　　者：张志宏[1] 许海雄[1] 柳隆华[1] 罗友章[1] 

机构地区：[1]广东省汕头市中心医院神经外科,广东汕头515031

出　　处：《海南医学》2004年第8期31-32,共2页Hainan Medical Journal

摘　　要：目的 通过对颅骨修补术后病人并发症的治疗,分析发生并发症的可能原因,并提出防治措施。方法:对自1989年9月-2003年8月我科共施行颅骨缺损修补术234例病人,进行随访1个月-12年。对其中发生并发症的40例病人进行认真的修正治疗。结果 发生并发症的40例病人为:切口感染15例,皮下积液8例,癫痫发作5例,继发骨窗出血4例,植片下陷3例,皮下积脓3例,肺部感染2例。其中1例因发生骨窗处硬膜下血肿,抢救不及时致死亡外,其余39例经处理后痊愈出院。结论 我们对颅骨缺损病人进行修补术时,应严格掌握手术指征及时机。老年病人,有呼吸道感染者应先控制症状。对术野应严格消毒,术中按操作规程进行,悬吊硬膜及缝扎时应避免损伤血管。建议全层缝合头皮,术毕于皮缘外留置胶管引流。Objective During the procedure to therapy paliena who had complications after skull prosthesis, Weanalysised the possible reasons and suggested some measures of prevention and cure . Method Our divison have done 234 cases of skull prosthesis during 1989.9 to 2003.8,and followed up them in one months to twelve years .WE have done revision cure to 40cases in which have occurred complications. Result The 40 cases who had occurred complications are: 15 cases of infection incisional wound,8 cases ssubcutaheous hoard-fluids,5 cases of epileptic attack,4 cases of secondary ossa-window,3 cases of trapped removed-hond piece,3 cases of subcutaheous empyema,2 cases of lung infection.The one case had a subdural hematoma in bone-window and dead because of no salvage in lime ,other 39 cases had fully recovered via rescue. Conclusion We should strictly grasped the conditions and occasions of operation when we want to do prothesis of skull coloboma .The gerontism patiens and the patiens who have infection of respiratory tract should treat the symptoms first .We should strictly treat the sterilization of operative field,operate according to the dispiplines,not to damage blood vessel when slinged duramaler and transfixion.We suggested to suture omni-layer and detain a glue drainage-tube in margins of derm.

关 键 词：颅骨修补术 术后并发症 预防 治疗 切口感染 癫痫 皮下积脓 

分 类 号：R687.3[医药卫生—骨科学]