超早期颅骨修补术对皮瓣分离时间及术中出血量的影响  

Effects of early cranioplasty on dissection duration and intraoperative blood loss in the patients with cranial defects after decompression craniectomy

作　　者：宋健[1] 刘敏 杜浩[1] 黄河[1] 何远志[1] 孙荣辉[1] 李德培[1] 徐国政[1] 

机构地区：[1]广州军区武汉总医院神经外科,武汉430070 [2]解放军第457医院眼科,武汉430012

出　　处：《中国临床神经外科杂志》2014年第6期337-339,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨超早期(去骨瓣减速压术后6周内)颅骨修补术对皮瓣分离时间及出术中血量的影响。方法选取自2010年3月至2011年3月收治的行超早期颅骨修补术25例颅骨缺损患者为超早期修补组。选择同期去骨瓣减压术后3月以上行颅骨修补术颅骨缺损患者18例为对照组。对比分析两组患者的术中出血量、术中皮瓣分离时间的差异。结果超早期颅骨修补组患者的皮瓣分离时间[(12.9±7.2)min]较对照组[(30.1±10.8)min]明显缩短(P<0.01),而术中出血量[(226.3±40.3)ml]较对照组[(381.5±58.9)ml]明显减少(P<0.01)。术后3月、6月患者均来院复查头颅CT,所有患者均未见脑积水、感染、硬膜下积液、头皮愈合不良等并发症。结论在严格选择适应症的前提下,超早期颅骨修补术有利于减少术中出血,缩短皮瓣分离时间,且其并发症发生率并未升高。Objective To explore the effects of early cranioplasty on dissection duration and intraoperative blood loss in the patients with cranial defects after decompression craniectomy. Methods The eranioplasty was performed in our hospital 6 weeks after deeompressive eranieetomy in 25 patients with traumatic brain injury （TBI） from March, 2009 to December, 2012, in whom, the dissection duration and the blood loss were measured during the surgery. The cranioplasty was performed 3 months after the decompressive eranieetomy in 18 patients with TBI serving as control group. Results The duration of dissection [（12.9±7.2） min] was significantly shorter and the volume of blood loss [（226.3±40.3） ml] was significantly fewer in the early cranioplasty group than those [the duration of dissection and the volume of blood loss were （30.1±10.8） min and （381.5±58.9） ml respectively] in the control group （P〈0.01）. Conclusion The early cranioplasty under the operative indication is better than the late eranioplasty because the early cranioplasty may decreases the dissection duration and intraoperative blood loss in TBI patients with cranial defects after the deeompressive cranieetomy.

关 键 词：颅骨缺损 颅骨修补术 皮瓣分离时间 术中出血量 超早期 

分 类 号：R651.15[医药卫生—外科学] R651.11[医药卫生—临床医学]