内镜下应用带血管蒂的鼻中隔黏骨膜瓣修复颅底硬膜缺损疗效分析  

Analysis of curative effect complications and recurrence rate of endoscopic application of nasal septal periosteum flap with vascular pedicle in the repairing of dura mater defect of skull base

作　　者：李青峰[1] 王嫒[1] 董瑞[1] 

机构地区：[1]山西医科大学第二医院,山西太原030001

出　　处：《基层医学论坛》2017年第34期4777-4779,共3页The Medical Forum

摘　　要：目的分析内镜下应用带血管蒂的鼻中隔黏骨膜瓣修复颅底硬膜缺损的临床疗效。方法选择我院2011年4月—2017年4月收治40例颅底硬膜缺损患者,依据治疗方法不同分为内镜下应用带血管蒂的鼻中隔黏骨膜瓣组(修复组,n=20)和内镜扩大经鼻入路手术组(切除组,n=20)2组,对2组患者的临床疗效、术后并发症发生情况及复发情况进行统计分析。结果修复组患者治疗总有效率为90.0%,显著高于切除组的70.0%(P<0.05);修复组术后并发症发生率、复发率均显著低于切除组(P<0.05)。结论内镜下应用带血管蒂的鼻中隔黏骨膜瓣修复颅底硬膜缺损较内镜扩大经鼻入路手术效果更为显著,且具有较少的并发症,较低的复发率。Objective To analyze the curative effect,complications and recurrence rate of endoscopicapplication of nasal septal periosteum flap with vascular pedicle in the repairing of dura mater defect of skull base.Methods The clinical data of 40 cases of patients with dura mater defect of skull base in our hospital from April2011 to April 2017 were statistically analyzed,these patients were divided into endoscopic application of nasal septalperiosteum flap with vascular pedicle group （repair technology group,n=20）and endoscopic endonasal approachsurgery group（resection technology group,N=20）two groups according to the treatment methods,the clinical efficacy,postoperative complications and recurrences of the two groups were statistically analyzed.Results The total effectiverate of the repair technology group 90.0%（18/20）was significantly higher than the resection technology group 70.0%（14/20）（P〈0.05）,the incidence of postoperative complications,recurrence rate 10.0% （2/20）,5.0% （1/20）weresignificantly lower than the resection technology group 25.0%（5/20）,15.0%（3/20）（P〈0.05）.Conclusion Thecurative effect of endoscopic application of nasal septal periosteum flap with vascular pedicle in the repairing of duramater defect of skull base is more significant than endoscopic endonasal approach surgery,and it has lesscomplications and lower recurrence rate.

关 键 词：颅底硬膜缺损 内镜 带血管蒂的鼻中隔黏骨膜瓣 疗效 并发症 复发率 

分 类 号：R651.1[医药卫生—外科学]