小儿先天性颅缝骨化症的手术治疗（附八例报告）  

Surgical management for infantile with congenital ossification of cranial sutures （ report of eight cases）

作　　者：齐林[1] 芦山[1] 张磊[1] 冯书彬[1] 何心[1] 董留建[1] 吕强[1] 

机构地区：[1]郑州市儿童医院神经外科,450053

出　　处：《中华神经外科杂志》2014年第1期63-66,共4页Chinese Journal of Neurosurgery

摘　　要：目的探讨小儿先天性颅缝骨化症的手术时机、手术方式、预后及发病的相关危险因素。方法回顾性分析郑州市儿童医院神经外科2008年1月至2012年11月收治的8例小儿先天性颅缝骨化症临床资料；手术年龄：3个月以内2例，4—6个月2例，7个月～1岁3例，1岁1个月1例。手术方式：对于矢状缝早闭患儿，采用David“Ⅱ”型颅缝重建术，其他病理类型，则根据颅缝钙化部位不同，采取相应钙化颅缝重建，并用不吸收人工硬膜修补材料包裹再造颅缝两侧边缘，防止颅缝过早愈合。结果术后6个月对患儿进行随访，通过手术前、后头颅横径与前后径之比（颅骨指数）的变化，对头颅外形改善情况进行评估。手术前后颅骨指数变化：8例患儿术前颅骨指数分别为：68．9％，69．9％，69．7％，65．2％，67．3％，68．4％，69．6％，67．9％。术后半年颅骨指数分别为77．0％，77．1％，73．1％，69．7％，72．2％，72．5％，73．9％，71．5％。结论在患儿可耐受手术的前提下，尽早手术，以达到满意的治疗效果。根据颅缝钙化情况，行相应钙化骨缝重建术。人工硬脑膜材料填充再造骨缝安全可靠。Objective To investigate the operation timing, surgical approach and risk factors of craniosynostosis in infantile. Methods Retrospective analysis 8 infantile with craniosynostosis in with clinical data between January 2008 and November 2012 in Zhengzhou Children Hospital. Age at surgery were as following, 2 cases younger than 3 months , 4 -6 months in 2 cases,7 - 12 months in 3 cases, 1 year to 2 years old 1 case. Operation method ： According to the type of joint closure, use the corresponding operation method. Evaluate postoperative anterioposterior and transverse diameter of the skull. Reconstruction with artificial dural repair materials cranial seam on both sides of the edge, prevent premature cranial suture to heal. Results All eight patients had no complications after surgery. Postoperatively anterioposterior and transverse diameter ratio of skull significantly improved. Skull shape has also been improved accordingly. Preoperative Cranial index was ： （ 68.9%, 69~ 9%, 69. 7%, 65.2%, 67.3%, 68.4%, 69. 6%, 67. 9% ） ; postoperative Cranial index was （77. 0% ,77. 1% ,73. 1% ,69.7% ,72. 2% ,72. 5% ,73.9% ,71.5% ） . Conclusions In infantile early surgery can achieve satisfactory results, cranial suture ossification status is important for selection of corresponding operation method. Artificial dura mater is safe and reliable for filling the suture.

关 键 词：先天性颅缝骨化症 颅缝重建术 颅骨指数 

分 类 号：R726.5[医药卫生—儿科]