颅骨生长性骨折16例临床分析  

Growing Skull Fractures: Clinical analysis of 16 cases

作　　者：李欢[1] 周大彪[1] 钱海燕[1] 甲戈[1] 马振宇[1] 

机构地区：[1]首都医科大学附属北京天坛医院神经外科,北京100050

出　　处：《山东大学学报（医学版）》2011年第12期103-106,共4页Journal of Shandong University:Health Sciences

摘　　要：目的探讨颅骨生长性骨折的发病机制,总结其临床特点及防治原则。方法回顾性分析16例颅骨生长性骨折患儿的临床资料。所有患儿均行手术治疗,其中行开颅软化灶清除及硬膜修补术15例,行对侧脑室腹腔分流术1例。分析其发病机制、临床及影像学特点。结果所有手术均获得成功,行开颅的患儿扩大切除增生颅骨,水密性严密修补硬膜。根据病情术中一期行骨片复位、钛板修补或择期行颅骨修补手术。术后出现皮下积液6例,经腰穿置管或行积液-腹腔分流术皮下积液得以控制。4例癫痫患儿中3例癫痫症状停止。随访平均3.5年,所有患儿均无复发。结论硬膜撕裂是发生生长性骨折的必要条件,其治疗关键为手术严密修补硬膜。Objectives To discuss the pathogenesis,clinical characteristics and the therapeutic strategies of growing skull fractures.Methods 16 cases of growing skull fractures were retrospectively studied.All patients underwent operations.Total resection of leptomeningeal cyst herniation and watertight repair of the dura were achieved in 15 patients.One patient underwent a ventriculoperitoneal shunt operation.The pathogenesis,clinical and radiological features of these patients were reviewed.Results All the procedures were successfully performed.The dural defect extended beyond the bony defect.The bone window was removed to expose the dural margins for a satisfactory dural repair.Cranioplasty was performed during the operations using steel plates or autologous bone several months after the operation.There was no recurrence during the follow-up.Six patients developed subcutaneous effusions.Three of four patients presenting with seizure were seizures-free after the operation.Conclusions A dural tear is crucial for the development of growing skull fractures.The key procedure is a watertight repair of the dura.

关 键 词：颅骨骨折 发病机制 病例分析 

分 类 号：R683.5[医药卫生—骨科学]