颅骨修补手术方式的选择  

The selection of surgical methods for cranioplasty

作　　者：方新运[1] 陈三送[1] 狄广福[1] 朱明峰[1] 邵雪非[1] 江晓春[1] FANG Xin-yun(The neurosurgery department, Yijishan hospital of Wannan Medical College,Wuhu,Anhui, 241000,China)

机构地区：[1]皖南医学院弋矶山医院神经外科,安徽芜湖241000

出　　处：《齐齐哈尔医学院学报》2019年第7期820-822,共3页Journal of Qiqihar Medical University

基　　金：皖南医学院中青年课题(WK2017F06)

摘　　要：目的 探讨颅骨修补术式的选择,降低术后并发症。方法 回顾性分析2014年1月—2018年1月本院神经外科使用数字化钛板行颅骨修补的140例额颞部颅骨缺损患者的临床资料,根据术中肽板放置位置,将患者分为颞肌下组(钛板放置在颞肌下)和颞肌外组(钛板放置在颞肌外)两组。结果 颞肌下组60例,其中术后硬膜外血肿患者6例(10%),皮下积液12例(20%),癫痫发作3例(5%),颞部皮肤凹陷0例;颞肌外组80例,其中术后硬膜外血肿0例,皮下积液5例(6%),癫痫0例,颞部皮肤凹陷10例(12.5%)。两组在发生硬膜外血肿、皮下积液上比较,颞肌外组优于颞肌下组(P<0.05);在颞部皮肤凹陷上比较,颞肌下组优于颞肌外组(P<0.05);在癫痫发作上比较,两组无统计学差异(P>0.05)。结论 颞肌下组60例,其中术后硬膜外血肿患者6例(10%),皮下积液12例(20%),癫痫发作3例(5%),颞部皮肤凹陷0例;颞肌外组80例,其中术后硬膜外血肿0例,皮下积液5例(6%),癫痫0例,颞部皮肤凹陷10例(12.5%)。两组在发生硬膜外血肿、皮下积液上比较,颞肌外组优于颞肌下组(P<0.05);在颞部皮肤凹陷上比较,颞肌下组优于颞肌外组(P<0.05);在癫痫发作上比较,两组无统计学差异(P>0.05)。Objective To discuss the selection of surgical methods for cranioplasty and to reduce the postoperative complications.Methods The clinical data of 140 cases of patients suffered with frontotemporal skull defect those who received cranioplasty by using digital titanium plate from January 2014 to July 2018 in neurosurgery department of Yijishan hospital of Wannan Medical College were retrospectively analyzed.They were divided into sub-temporal group( the titanium plate was placed under temporalis muscle) and extra-temporal group( the titanium plate was placed outside temporalis muscle). Results There were 60 cases in the sub-temporal group,6 cases( 10%) with epidural hematoma,12 cases( 20%) with subcutaneous effusion,3 cases( 5%) with epilepsy and 0 cases with temporal skin depression.80 cases in the sub-temporal group,0 cases with epidural hematoma,5 cases( 6%) with subcutaneous effusion,0 cases with epilepsy and 10 cases( 12.5%) with temporal skin depression. The incidence of epidural hematoma and subcutaneous effusion in the extra-temporal group was better than that in the sub-temporal group( P< 0.05). In the temporal skin depression sub-temporal group was better than in the extra-temporal group( P < 0. 05). There was no significant difference in epilepsy between the two groups( P > 0. 05). Conclusions Both methods have advantages and disadvantages.Individualized surgery should be adopted according to specific patients.

关 键 词：颅骨修补 颞肌 并发症 

分 类 号：R651.1[医药卫生—外科学]