硬膜双层缝合在额颞区大骨瓣减压术后颅骨缺损修补中的应用  

Application of dural bilaminar saturation in frontal-temporal skull defect repairs after standard decompres-sive craniectomy

作　　者：王志强[1] 周贤文[1] 贾强[1] 王宗宝[1] 

机构地区：[1]滨州医学院附属滨州市中心医院神经外科,山东省滨州251700

出　　处：《中国基层医药》2015年第17期2604-2606,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的：探讨硬脑膜双层缝合在额颞区大骨瓣减压术后修补颅骨缺损的手术效果。方法回顾性分析52例额颞顶颅骨缺损患者的临床资料，均行钛网颅骨修补术，根据第一次去骨瓣减压术中硬膜修补情况分为两组，观察组（硬膜双层缝合）27例，应用自体膜扩大修补后在其上方加缝一层人工硬膜，位于颞肌与硬脑膜之间。对照组（硬膜单层缝合）25例，应用人工硬膜直接扩大修补硬膜。比较两组患者行颅骨修补时手术时间、出血量、术后并发症等情况。结果（1）手术时间：观察组为（65．00±8．15）min，对照组为（83．00±10．25）min，两组差异有统计学意义（t＝7．059，P＜0．05）；（2）出血量：观察组为（55±8）mL，对照组为（79士12）mL，两组差异有统计学意义（t＝8．541，P＜0．05）。（3）术后并发症：观察组术后并发症4例（14.8％），对照组术后并发症5例（20％），两组差异无统计学意义（χ2＝0．016，P＞0．05）。结论硬脑膜双层缝合在额颞区大骨瓣减压术后行二次手术修补颅骨缺损时能明显缩短手术时间，减少术中出血量。Objective To approach the operative effect of dural bilaminar saturation in frontal -temporal skull defect repairs after standard decompressive craniectomy.Methods Fifty-two patients with titanium cranioplas-ty in frontal-temporal skull defect were retrospectively analyzed;27 of them adopted dural bilaminar saturation in the first standard decompressive craniectomy（test group）;25 of them adopted dural monostratal saturation in the first operation （control group）.The operation time,blood loss,postoperative complications in the two groups were compared.＆amp;nbsp;The mean operation time：the test group was （65.00 ±8.15）min and the control group was （83.00 ± 10.25）min,there was statistically significant differences between the two groups（t =7.059,P〈0.05）;average amount of bleeding：the test group was （55 ±8）mL and the control group was （79 ±12）mL,there was statistically significant differences between the two groups （t=8.541,P〈0.05）;postoperative complications：adverse reactions were noted in 4 patients of test group （14.8%）,5 cases of control group （20%）,there was no significant differences between the two groups （χ2 =0.016,P〉0.05）.Conclusion Skull repairs in second standard decompressive crani-ectomy by dural bilaminar saturation,can be shortened the operation time and lessened amount of bleeding.

关 键 词：颅骨缺损 硬膜双层缝合 大骨瓣减压术 

分 类 号：R651.11[医药卫生—外科学]