外伤性中后段上矢状窦损伤的初步治疗经验(附21例临床分析)  

The repair of the middle and posterior third traumatic superior sagittal sinus rupture

作　　者：耿建国[1] 薛诚[1] 张玉勇[1] 李剑侠[1] 

机构地区：[1]江苏省南京市东南大学附属南京江北人民医院神经外科,南京210048

出　　处：《立体定向和功能性神经外科杂志》2012年第5期294-296,共3页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的探讨外伤性中后段上矢状窦损伤的治疗经验。方法总结我院自2000年6月至2012年6月间21例外伤性中后段上矢状窦损伤的临床资料及影像学特点,闭合性损伤16例,开放性损伤5例,依据破裂口大小及部位,分别采用直接电灼、电灼+明胶海绵填塞+ZT胶固定、直接缝合、自体骨筋膜缝合、硬膜翻转及自体大隐静脉重建等方法修补。结果术后48小时内头部CT复查未见再手术征象,治愈13例,轻度偏瘫4例,严重瘫痪1例,单纯或合并感觉异常5例,长期昏迷1例,死亡1例。结论外伤性中后段上矢状窦损伤术前充分准备,术中处置恰当可取得良好的效果。Objective To explore the treatment of the middle and posterior third traumatic superior sagittal sinus rupture. Methods The clinical date of 21consecutive patients with the middle and posterior third traumatic superior sagittal sinus rupture including closed craniocerebral injuries（n=16） and open craniocerebral injuries（n=5） were retrospectively analyzed in our hospital from Jun 2000 to Jun 2012.Electric coagulation,electric coagulation ＋ gelatin sponge ＋ ZT glue,direct suture,pericranium graft,encephalodurosynangiosis and vessel reconstruction were used. Results Head CT scan Post-op 48 hr showed no or litter hematomas.Follow-up for 6-12 months.Outcome is good（n=13）.Complications include mild palsy（n=4）,severe paralysis（n=1）,simple or combined paraesthesia（n=5）,long coma（n=1） and death（n=1）. Conclusion Careful examination,reasonable design of repair plan and fine manipulation play a key role in the repair of the middle and posterior third traumatic superior sagittal sinus rupture.

关 键 词：上矢状窦 修补 外伤 

分 类 号：R741[医药卫生—神经病学与精神病学]