硬脑膜翻转法修补外伤性上矢状窦损伤研究  

Encephalodurosynangiosis to Repair Superior Sagittal Sinus Rupture

作　　者：王强[1] 邱胜利[1] 赵俊山[1] 王林[1] 贾德群 

机构地区：[1]安徽省合肥市第二人民医院神经外科,230011

出　　处：《中华全科医学》2010年第4期423-424,共2页Chinese Journal of General Practice

摘　　要：目的探讨硬脑膜翻转法修补外伤性矢状窦损伤的疗效。方法16例外伤性上矢状窦损伤病例。均全麻下手术,作略大于骨折或血肿范围的马蹄形皮瓣,或"H"形头皮切口,骨瓣开颅。明确上矢状窦破裂的部位后,弧形剪开窦旁的硬膜,一边用明胶海绵加肌肉片堵塞出血点,一边将硬膜向中线翻卷,固定在对侧的硬膜或筋膜上。骨板整复后复位固定,硬膜外放置引流管。结果16例均止血成功,平均修补时间25min,术中及术后平均输血2400ml。术后1～3d复查CT,硬膜外血肿复发率为0%。其中5例MRV检查,均显示上矢状窦畅通。随诊3个月,13例恢复良好,2例下肢轻瘫,1例死于广泛脑挫伤。结论硬脑膜翻转法止血可靠、填塞物少,是修补外伤性矢状窦损伤的良好方法。Objective To improve the effect of Encephalodurosynangiosis to repair sagittal sinus rupture.Methods 16 cases of traumata superior sagittalis sinus rupture were chosen,operation was in general anesthesia,all cases did horseshoe or ＂H＂ shap skin flap which bigger than born fracture or haematoma bound,and craniotomy with bone flap.After clarified cracked region,endocranium was opened in arc shape,builting up hemorrhagic spot with gelatin sponge plus muscle piece,as well as turnning over openning endocranium,fixed to contralateral putamen or fasciae.Reducing born-board,and drainage tube seting outside endocranium.Results 16 cases were hemostasis completely,average repairing time was 25 minutes,average blood transfusion was 2 400 ml.CCT was checked after opration 1-3 d,extradural hematoma recurernce rate was 0.5% cases were checked with MRV,in showed superior sagittal sinus passage easy and smooth.Following up was 3 months,13 cases recovered well,2 case got paraparesis,1 case died from abroad brain contusion.Conclusion Encephalodurosynangiosis to repair superior sagittal sinus rupture was credibility for hemostasis and plugger fewness.

关 键 词：上矢状窦 硬脑膜翻转 修补 

分 类 号：R651.15[医药卫生—外科学] R641[医药卫生—临床医学]