一期修复颅骨粉碎性骨折41例  

One stage repair of comminuted skull fracture: a report of 41 cases.

作　　者：庄之剑[1] 王青松[2] 林婷婷[2] 李钢[2] 

机构地区：[1]文昌市人民医院外三科,海南文昌571300 [2]中国人民解放军总医院海南分院神经外科,海南三亚572013

出　　处：《海南医学》2013年第3期398-400,共3页Hainan Medical Journal

摘　　要：目的探讨应用自体碎骨片行颅骨粉碎性骨折一期修复的方法及效果。方法对41例颅骨粉碎性骨折常规清创处理,将碎骨片用聚维酮碘处理后,再以1‰庆大霉素生理盐水浸泡,复位于骨缺损区,从骨片间隙中将硬脑膜与帽状腱膜对应缝合固定骨片,头皮分层缝合。结果所有病例无感染及皮下积液,术后复查X线颅骨片或头颅CT扫描显示颅骨碎片愈合,外观塑形好。结论颅骨粉碎性骨折摘除碎骨片将造成颅骨缺损,将碎骨片复位修复愈合良好,减少了患者再次手术的痛苦,有利于患者康复,对脑组织起到很好的保护作用。Objective To observe and study the clinical effect of surgical repair using broken skull pieces in the treatment of comrninuted skull fracture. Methods Forty-one patients with comminuted skull fracture underwent debridement in acute stage. The broken skull pieces was taken out, disinfected with povidone iodine, and soaked in 1‰ gentamicin/normal saline for more than 30 minutes. Then the broken pieces were replaced into the defect area ac-cording to the original shape, and duramater was sewed to galea between the bone pieces in order to fix these pieces. The scalp was sewed according separated layers to close wounds. Results No infection and subcutaneous accumula-tion of liquid were found in any of the patients after operation. The X ray reexamine or CT scanning showed coales-cence between the broken skull pieces and satisfactory remodeling of the skull appearance. Conclusion The extrac-tion of the broken skull pieces from the wound leads to skull defect after operation. Repairing the defect with the bro-ken skull pieces can reduce the patient＇s suffering from the second operation, which is a good method to protect brain tissue well.

关 键 词：颅脑创伤 颅骨骨折 颅骨成形术 

分 类 号：R683.5[医药卫生—骨科学]