静脉窦区凹陷性颅骨骨折的微创手术治疗  

Minimally Invasive Surgery for Depressed Skull Fracture in Venous Sinus Areas

作　　者：吴建波[1] 杨清[1] 周明森[1] 

机构地区：[1]四川省达州市第二人民医院神经外科,达州635000

出　　处：《成都医学院学报》2015年第2期213-215,共3页Journal of Chengdu Medical College

摘　　要：目的总结17例静脉窦区凹陷性骨折的微创手术治疗经验。方法回顾性分析2011年1月至2014年10月达州市第二人民医院神经外科收治的17例静脉窦区凹陷性骨折患者的临床表现、微创手术过程及治疗效果。结果 17例静脉窦区凹陷性骨折患者均行微创手术,其凹陷骨折所致压迫均得以解除。术中发现7例静脉窦损伤,其中5例为上矢状窦损伤,2例为横窦损伤。16例患者术中出血少,未输血;1例顶部矢状窦损伤患者大出血。9例一期行凹陷骨折整复并固定。所有患者临床症状及神经功能短期内均有改善,且随访2个月至3年均恢复正常。结论应用显微镜及显微磨钻等微创技术治疗静脉窦区凹陷性骨折,可减少创伤,安全性高、疗效满意。Objective To summarize our experiences with minimally invasive surgery of 17 cases with depressed skull fracture in venous sinus areas. Methods From January 2011 to October 2014, 17 patients with depressed skull fracture in venous sinus areas in Department of Neurosurgery, the Second People＇s Hospital of Dazhou were treated in our department. Clinical data of patients including clinical manifestation, image features, microsurgery and therapeutic outcomes were analyzed retrospectively. Results Minimally invasive surgery was delivered to all patients,and the compressions caused by depressed skull fracture were lifted. Venous sinus injury was found in 7 patients in operation： the sagittal sinus was broken in 5 cases,and the transverse sinus was damaged in 2 cases. There was no blood transfusion in 16 patients with less bleeding in operation. Intraoperative massive hemorrhage and blood transfusion appeared in 1 patient with damage at the top of superior sagittal sinus. Among the 17 cases, 9 cases underwent one stage of depressed fracture reduction and fixation. Significant improvements in neurological functions were found in all cases in the early stage after operation. The patients were followed up from 2 months to 3 years,all of them recovered completely. Conclusion In the treatment of venous sinus region depression fracture,minimally invasive technique, mainly including the application of microscopy and micro grinding drill, may reduce trauma,increase security and offer a favorable outcome.

关 键 词：静脉窦 凹陷性骨折 微创手术 

分 类 号：R683.42[医药卫生—骨科学]