新生儿单纯颅骨凹陷骨折的非手术治疗  

Non-surgical therapy on skull simple depressed fractures in neonate

作　　者：余雷[1] 余腾[2] 胡家高[1] 

机构地区：[1]武汉市儿童医院新生儿外科,430016 [2]江汉大学医学院

出　　处：《中华小儿外科杂志》2012年第12期881-885,共5页Chinese Journal of Pediatric Surgery

摘　　要：目的探讨非手术方式治疗新生儿单纯颅骨凹陷性骨折的可行性。同时结合文献复习，期望为新生儿颅骨凹陷骨折提供一个合理的治疗方案。方法回顾分析1997年8月至2012年2月非手术治疗的11例新生儿单纯颅骨凹陷性骨折的临床转归。全部病例均是出生后即发现颅骨凹陷。入院年龄为出生后9h-17d，凹陷深度0．3-1．0cm，其中6例凹陷深度〉0．5cm。合并颅内出血4例，有神经系统症状1例。10例采取观察，待其自然恢复；1例采取产科负压吸引器抽吸颅骨凹陷。结果10例观察患儿颅骨凹陷在1-7个月后恢复，没有后遗神经系统并发症；1例颅骨凹陷使用产科负压吸引器抽吸后，颅骨凹陷立即恢复。复查脑CT，原有颅内出血灶无增大，颅内颅外也未见新出血灶及病变。结论非手术疗法可成为新生儿单纯颅骨凹陷性骨折之选择；在不增加危险的情况下，负压抽吸术是一种快速解决更大而深骨折凹陷的选择，还可以减轻患儿家属的焦虑情绪。Objective The purpose of this study is to offer a rational principle for neonate suf- fering from skull simple depressed fractures through the investigation of non-surgical therapy and rele- vant references review. Methods Between August 1997 and February 2012, total 11 neonates under- went non-surgical treatment in our department and better efficacy was found in them. Their clinical da- ta was reviewed and analyzed. All （;f them were diagnosed as skull depressed fractures in post-born and admitted once definite diagnosis. The depressed depth ranged from 0. 3 cm to 1.0 cm in depth and 6 of them were more than 0. 5 era. 4 cases were found to be complicated with intracranial hemorrhage, only 1 case presented nervous symptoms. 10 cases underwent the conservative therapy and vacuum ex- traction was performed in 1 case. Results Spontaneous restoration was observed in 10 patients within a period ranging from 1 to 7 months and no neurological deficits was found in them. 1 case who under- went vacuum extraction recovered without complications. Conclusions non-surgical therapy can be a reasonable option for neonates with skull simpIe depressed fractures. Under the situation of safety, vacuum extraction is also an approach in therapy of neonate with deeper depressions, which contrib- utes to relieve anxieties to their family.

关 键 词：婴儿 新生儿 颅骨骨折 治疗 

分 类 号：R726.8[医药卫生—儿科] R722.1[医药卫生—临床医学]