硬脑膜量化减张缝合在去骨瓣减压术中的应用  

Application of quantitive tension reduction to dural suture in the decompressive craniotomy

作　　者：司文 王铁军 牛国盛 王文杰 江坤 吴瑞岳 

机构地区：[1]深圳市观澜人民医院神经外科,广东深圳518110

出　　处：《皖南医学院学报》2011年第1期28-30,共3页Journal of Wannan Medical College

基　　金：深圳市科技计划项目(200903169)

摘　　要：目的:探讨重型颅脑损伤标准大骨瓣减压术中,减张程度量化的硬脑膜减张缝合技术的可行性和疗效。方法:将81例符合手术指征的重型颅脑损伤病人随机分为A组和B组,A组40例行标准大骨瓣减压,术中于硬脑膜张力性缺损区嵌插量化(26.5 cm2)的人工硬脑膜补片行减张缝合。B组41例行标准大骨瓣减压,硬脑膜敞开。比较两组术后并发症及疗效。结果:A组术后并发脑积水、硬膜下积液、脑脊液漏发生率明显低于B组(P<0.05);A组颅骨修补术平均时间短、出血量少等差别较B组有显著意义。半年后评价A组GOS评分高于B组。结论:基于量化的硬脑膜减张缝合技术切实可行,有效减少并发症,改善预后,值得推广应用。Objective：To investigate the feasibility and efficacy of quantitive dural de-stretching suturing for tension reduction in standard large trauma craniotomy of severe head injury.Methods： Eighty-one patients eligible for severe craniocerebral injury were randomized into groups of A（n=40） and B（n=41）.Group A received standard large trauma decompression by quantitively applying artificial dural patch of 26.5 cm2 to the defects for de-stretching suturing,while group B were treated by standard large trauma decompression with opened dura.The two groups were analyzed regarding the complications and outcomes.Results： The incidences of hydrocephalus,subdural effusion and cerebrospinal fluid leakage were significantly lower as compared with group B（P0.05）.Shortened operation time and less blood loss were also found in group A besides higher GOS scores.Conclusion： Quantitive dural de-stretching suturing for craniotomy appears feasible and can be in wider clinical use,for it will reduce the complications and improve the prognosis of such injury.

关 键 词：标准大骨瓣减压术 减张缝合 颅脑损伤 量化 

分 类 号：R651.15[医药卫生—外科学]