颅骨缺损修补与颅底重建术——诊断与治疗  

Cranioplasty of skull vault defect and skull base reconstruction: diagnosis and management

作　　者：费舟[1] 章翔[1] 刘卫平[1] 张剑宁[1] 付洛安[1] 蒋晓帆[1] 贺晓生[1] 宋少军[1] 

机构地区：[1]第四军医大学附属西京医院全军神经外科研究所,西安710032

出　　处：《中华创伤杂志》2006年第10期728-730,共3页Chinese Journal of Trauma

基　　金：国家自然科学基金(39870673)

摘　　要：目的探讨颅盖与颅底骨缺损修补手术的诊断、治疗与手术技巧,以期提高此类患者的治疗质量。方法对近5年来收治的169例颅盖和颅底骨缺损患者的临床资料进行回顾性分析,总结其临床特点与治疗经验。结果手术材料选用进口钛板160例,自体骨9例；颅盖骨缺损修补手术时间为缺损后3个月～8年；手术方法有覆盖法和镶嵌法。8例出现不同程度的术后血肿、感染、癫痫等并发症,无手术死亡患者。结论对于颅盖骨缺损直径≥3cm、颅骨缺损时间≥3个月的患者可进行手术；颅内外沟通瘤的颅底骨缺损者可在肿瘤切除后进行修补,应注重相应的围手术期处理与手术技巧。Objective To discuss and analyze the diagnosis, management and surgical techniques for cranioplasty of skull vault defects and skull base reconstruction in order to raise the therapeutic effect, Methods The clinical data of 169 cases of skull vault and skull base defects treated with cranioplasty of skull vault defect and skull base reconstruction were retrospectively analyzed. Results Overlay technique or inlay technique with imported titanium alloy mesh was used in 160 cases, and homologous bone was used in 9 cases. The surgical time ranged from 3 months to 8 years after injury. Eight cases presented with complications such as hematoma, subcutaneous effusion, infection and epilepsy postoperatively, but no operative death occurred. Conclusion For patients with skull vault defect with the diameter ≥ 3 cm the best operative time is 3 months after injury, and for patients with intracranial and extracranial communicating tumors, skull base reconstruction can be performed when tumors are removed. Much attention should he paid to perioperative management and surgical skills.

关 键 词：颅骨缺损 诊断 颅骨成形术 

分 类 号：R651.1[医药卫生—外科学]