生物膜在经鼻蝶入路手术鞍底重建中的应用  

Application of biomembranes in sellar reconstruction of transsphenoidal surgery

作　　者：张祥茂[1] 黄楹[2] 

机构地区：[1]天津医科大学研究生院,天津300070 [2]天津市环湖医院颅底外科,天津300060

出　　处：《第三军医大学学报》2014年第2期148-150,共3页Journal of Third Military Medical University

摘　　要：目的探讨生物膜在经鼻蝶入路手术鞍底重建中的应用方法及效果。方法显微镜下经鼻蝶入路手术治疗鞍区病变52例，利用多层生物膜进行有效鞍底重建，对鞍膈和鞍上池蛛网膜破损者同时用生物膜修补鞍膈。结果19例（36．5％）术中发生脑脊液漏，6例（11．5％）术中无脑脊液漏但鞍膈破损，行鞍膈修补，所有病例行鞍底重建。4例（7．7％）术后出现短期脑脊液鼻漏，平卧5～7d后均症状消失。随访3—48个月，无1例出现脑脊液鼻漏、细菌性脑膜炎和张力性气颅等。结论经传统鼻蝶入路切除病变后，利用合适生物膜修补鞍膈和多层重建鞍底，可安全、有效地预防术后及中远期脑脊液鼻漏等并发症。Objective To investigate the clinical application, techniques and efficacy of biomem- branes in reconstruction of the sella turcica in transsphenoidal surgery. Methods Transsphenoidal surgery was performed in 52 patients with lesions of sellar region. After removal of the lesions, sellar reconstruction with or with N diap out diaphragm recoustitution was performed using biomembranes according to different conditions. Results ineteen cases （36.5%） with intraoperative cerebrospinal fluid （CSF） leakage and 6 cases （ 11.5% ） with hragm defect but no intraoperative CSF leakage underwent diaphragm reconstitution. All cases underwent sellar reconstruction. The postoperative CSF leakage was found in 4 cases （7.7%）, which was cured by conservative therapy for 5 to 7 d. All patients were followed up for 3 to 48 months. No CSF leakage, bacterial meningitis, tension pneumocephalus or other complication was found. Conclusion Reconstruction of the sella turcica using appropriate biomaterials without any adhesive sealants can effectively and safely prevent postoperative and long-term CSF leakage and other complications in patients with traditional transsohenoidal surgery_

关 键 词：经蝶手术 鞍底重建 生物材料 多层 脑脊液漏 

分 类 号：R318.08[医药卫生—生物医学工程] R651.11[医药卫生—基础医学]