婴幼儿颅骨生长性骨折的手术治疗  

Surgical treatment for growing skull fracture in infants

作　　者：孙骇浪[1] 赵凤毛[1] 冀园琦[1] 

机构地区：[1]首都医科大学附属北京儿童医院神经外科,100045

出　　处：《中华神经外科杂志》2014年第12期1258-1261,共4页Chinese Journal of Neurosurgery

摘　　要：目的 探讨婴幼儿颅骨生长性骨折的临床特点,强调及早手术,一期自体颅骨修补与硬膜修补同是加速治愈的关键.方法 回顾性分析2008年9月至2013年12月间收治的经CT/MRI动态观察的12例3岁以下婴幼儿颅骨生长性骨折的临床资料.结果 5例采用人工脑膜腱修补硬脑膜＋自体骨瓣成型移位固定,成功治愈颅骨生长性骨折,3个月内颅骨均愈合.4例仅行硬脑膜修补,颅骨缺损处未行一期修补,效果尚满意,但术后随访,颅骨愈合时间较长.3例失访.结论 婴幼儿颅骨正处于生长发育期,应及早手术,早期清除坏死灶、严密缝合或修补硬脑膜,并采用自体骨瓣成型移位固定,一期还原硬脑膜和颅骨解剖形态,加速生长愈合,疗效确切.Objective To explore the clinical characteristics and treatment of infants growing skull fracture.Methods A retrospective study of 12 cases of infants under 3 years of age of growing skull fracture from 2008 September to 2013 December was performed.Results Five cases were treated with dural repair by artificial dura tendon and autologous bone flap molding shift.The growing skull fracture was healed within three months.The other 4 cases were treated with artificial dura tendon only for dural repair.The results were also satisfactory,but the bone healing time was long.The remaining 3 cases were lost during the followup period.Conclusion When the skull fracture line width was increased and/or dural breakage or brain hernia was found from the observation of dynamic CT/MRI,early surgical intervention should be performed to remove the necrotic foci,repair the dura,and use autogenous bone flap molding shift to fix the fracture,to accelerate the growth and healing of the fracture.

关 键 词：婴幼儿 颅骨生长性骨折 自体骨瓣成型 

分 类 号：R726.5[医药卫生—儿科]