标准大骨瓣减压术中硬脑膜减张程度的量化研究  

Quantitative study of the extent of dural de-stretching suture during the decompression of craniocerebral injury

作　　者：司文 江坤 蒋曼 牛国盛 

机构地区：[1]深圳市观澜人民医院神经外科,深圳518110

出　　处：《中国临床解剖学杂志》2010年第4期379-381,共3页Chinese Journal of Clinical Anatomy

基　　金：深圳市科技计划项目(200903169)

摘　　要：目的探讨与标准大骨瓣容积代偿相匹配的硬脑膜减张程度。方法通过对20例标准大骨瓣减压术患者减压窗的测量,算出成人平均容积代偿容积。通过尸体颅骨,模拟硬脑膜张力性缺损的过程,求出此容积引起硬脑膜张力性缺损的程度(面积用cm2表示),以此来量化硬脑膜减张程度。结果成人标准大骨瓣减压术平均容积代偿为81ml,其引起硬脑膜张力性缺损的面积为26.5cm2。影响因素包括:年龄、骨瓣范围、脑萎缩程度、迟发颅内血肿、脑水肿、脑梗塞程度、头皮张力等。结论硬脑膜减张缝合时,最佳硬脑膜减张程度为硬脑膜修补面积26.5cm2,实际工作中应结合容积代偿的影响因素略做增减。Objective To explore the extent of dural de-stretching suture matched with the standard large trauma volume compensatory.Methods 20 cases of standard large decompressive craniectomy were measured and calculated the average adult compensatory volume of the decompression of the measurement window.The skull of the cadavers were used to simulate the process of dura mater defects tension,and found the volume of defects caused by the extent of dural tension（area to express）,in order to quantify the reduce tension extent of dura mater.Results The average compensate volume of the adult standard large decompressive craniectomy was about 81ml,and the area caused dural tension defect was about 26.5cm2, which would be effected by the age,the range of bone flap,the degree of brain atrophy,delayed cerebral edema, intracranial hematoma,cerebral infarction,scalp tension and so on.Conclusions For dural de-stretching suture,the optimal repairing area of dura mater is about 26.5cm2,which should be revised according to the individual compensatory volume.

关 键 词：标准大骨瓣减压术 颅腔容积 减张缝合 数量化研究 代偿 

分 类 号：R651.11[医药卫生—外科学]