婴幼儿分离性颅骨骨折的早期处理—生长性颅骨骨折的预防  

Early treatment of the dissociated skull fracture in infant to aviod the growing skull fracture

作　　者：张丹[1] 李映良[1] 梁平[1] 夏佐中[1] 翟暄[1] 周渝冬[1] 

机构地区：[1]重庆医科大学附属儿童医院神经外科,重庆400014

出　　处：《激光杂志》2011年第5期76-78,共3页Laser Journal

摘　　要：目的:探讨生长性颅骨骨折早期有效的预防措施。方法:回顾性分析我院1990年1月至2009年12月收治63例婴幼儿分离性颅骨骨折的临床资料。结果:63例病儿颅骨骨折线宽度三3mm,其中52例CT或MRI提示有脑组织疝出或局部肿块穿刺抽出血性脑脊液或/和破碎脑组织者,经早期手术处理(包括坏死脑组织清除术和硬脑膜修补术),11例行非手术治疗,63例均成活,随访6月到3年和头颅CT复查,58例恢复正常,5例有脑软化灶;轻残3例,其中1例有外伤性癫痫。无生长性颅骨骨折发生。结论:婴幼儿颅骨骨折线宽度3mm和CT或MRl提示有脑组织疝出或局部肿块穿刺抽出血性脑脊液或/和破碎脑组织者,经早期手术清除坏死挫裂伤的脑组织术、严密缝合或修补硬脑膜,是预防生长性颅骨骨折发生的有效手段。Objective：To investigate the early and effective treatment to present the growing skull fracture. Methods： Retrospective analysis of the clinical data of 63cases with separation on dissociated skull fracture from January 1990 to December 2009 in our hospital. Result： The skull fracture line of sick children （63 cases） was greater than or equal to 3cm,the bloody cerebrospinal fluid and broken brain organizer were founded in the local mbss puncture and CT or MRI. 52 cases were performed the operation （ including the necrotic brain tissue dissection and duralplasty or dural repaired）, and 11 cases were treated conservatively. The 63 eases were survived. 58 cases were normal, encephalomalacia in 5 cases, mild disability in 3cases, including 1 ease of traumatic epilepsy followed up for 6 months to 3 years and head CT review. None of 63 cases take place the growing skull fracture. Conclusion： Early surgical treatment including removal of necrotic brain tissue laceralion, duralplasty or dural repaired was a effective mean to prevent the growing skull fracture in the sick infants with skull fracture line greater than or equal to 3cm and bloody cerebrospinal fluid and broken brain organizer were founded in the local mass puncture.

关 键 词：颅脑损伤 生长性骨折 治疗 婴幼儿 

分 类 号：R474[医药卫生—护理学]