颅骨修补时机对脑室系统的影响  

Impact of cranioplasty opportunity on the ventricle system

作　　者：葛宇曦[1,2] 崔恒武[1] 张联合[2] 严肃[1] 张士良[2] 

机构地区：[1]江苏大学临床医学院,江苏镇江212013 [2]武警浙江总队杭州医院放射科,浙江杭州310000

出　　处：《中国医学影像技术》2011年第12期2448-2450,共3页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨脑外伤颅骨修补前后脑室系统变化,为选择颅骨修补最佳时机提供影像学依据。方法收集脑外伤后接受颅骨修补术的53例患者的CT资料,根据修补前减压窗凹陷程度分为平坦组(20例)和凹陷组(33例),分别测量颅骨修补术前、后3脑室宽度及侧脑室大小(哈氏值),并对照分析两组患者颅骨修补前后脑室系统的变化。结果平坦组颅骨修补术后3脑室宽度平均增加(0.45±1.91)mm,哈氏值平均增加(1.70±11.41)mm,手术前后3脑室和侧脑室的变化差异无统计学意义(P>0.05);凹陷组颅骨修补术后3脑室宽度平均增加(3.73±2.97)mm,哈氏值平均增加(17.00±13.29)mm,手术前后3脑室及侧脑室变化差异有统计学意义(P<0.001)。结论脑外伤去大骨瓣减压术后减压窗平坦时行修补对脑室系统影响较小,凹陷时行颅骨修补对脑室系统影响较大,提示减压窗平坦时较适合进行颅骨修补术。Objective To observe the changes of ventricle before and after cranioplasty,in order to obtain imaging proof for the best opportunity of cranioplasty for patients with traumatic brain injuries.Methods CT data of 53 patients who underwent the cranioplasty after traumatic brain injury were collected.The patients were divided into plain group（20 cases） and depression group（33 cases） according to the depression degree of pressure-relief window.The width of the third ventricle and the Huckman＇s value were measured before and after cranioplasty,and then the data were compared and analyzed statistically.Results In plain group,after cranioplasty,the width of the third ventricle increased（0.45±1.91）mm,while in depression group,the width increased by（3.73±2.97）mm.The increment of Huckman＇s value was（1.70±11.41）mm in plain group and（17.00±13.29）mm in depressed group.There were significant changes of the third ventricle and lateral ventricle in depression group（P0.001）,but not in plain group（P0.05） before and after cranioplasty.Conclusion The impact of cranioplasty to the ventricle system in patients with traumatic brain injury is limited when the pressure-relief window is plain,but is obvious when the pressure-relief window is depressed,which suggests the better opportunity for cranioplasty is the pressure-relief window being plain.

关 键 词：颅骨 创伤和损伤 手术 3脑室 侧脑室 体层摄影术 X线计算机 

分 类 号：R651.1[医药卫生—外科学] R814.42[医药卫生—临床医学]