新生儿颅骨凹陷性骨折的治疗体会  

Experience in the treatment of skull depression fracture in neonates

作　　者：施伟 薛萍 赵瑞 李昊 Shi Wei;Xue Ping;Zhao Rui;Li Hao(Department of Neurosurgery,Children Hospital of Fudan University,Shanghai 201102,China)

机构地区：[1]复旦大学附属儿科医院神经外科,上海201102

出　　处：《中华神经外科杂志》2020年第6期570-573,共4页Chinese Journal of Neurosurgery

基　　金：上海市卫生和计划生育委员会科研课题(青年项目)(20164Y0086)。

摘　　要：目的探讨新生儿颅骨凹陷性骨折的治疗方案及临床疗效。方法回顾性分析2015年1月至2018年6月复旦大学附属儿科医院神经外科收治的10例新生儿颅骨凹陷性骨折患儿的临床治疗过程及转归。10例患儿的年龄为8~27 d;均无头部外伤史,且母孕期也无腹部外伤史。颅骨凹陷部位分别为额部2例、颞部3例、顶部5例。2例行手术复位,其中1例行颅骨撬起复位,1例行凹陷颅骨铣下整复后复位;余8例患儿均未行手术治疗,采取保守观察的方案。结果10例新生儿颅骨凹陷性骨折患儿中,2例行手术复位的患儿术后颅骨凹陷即时复位,术后无并发症发生,2个月的影像学随访显示颅骨均恢复至正常形态;余8例保守观察的患儿2~6个月的影像学随访显示颅骨凹陷性骨折均自然复位,未发生神经系统后遗症。3例合并出血的患儿随访时出血自行吸收,10例患儿均预后良好。结论大多数新生儿颅骨凹陷性骨折可以通过非手术治疗达到良好的临床效果,从而避免了手术及麻醉的风险。Objective To explore the treatment and clinical effects of skull depression fracture in neonates.Methods A retrospective analysis was performed on the clinical outcomes of 10 neonatal patients with skull depression fractures admitted to Department of Neurosurgery,Children Hospital of Fudan University from January 2015 to June 2018.The age of 10 patients was 8-27 d,none had a history of head trauma,and there was no history of abdominal trauma during pregnancy.There were 2 cases of frontal depression,3 cases of temporal depression and 5 cases of parietal depression.Among them,surgical reduction was performed in 2 cases,one cranial pry reduction,and cranial milling and reduction in 1.All the other 8 cases were treated by conservative observation.Results In 10 cases of neonatal skull depression fracture,2 patients had complete reduction of cranial depression without postoperative complications.The skull returned to normal shape after 2 months of imaging follow-up.Natural reduction of the skull without any neurological complication was observed in imaging follow-up(2-6 months)of 8 patients undergoing conservative treatment.Three patients with bleeding were followed up and bleeding absorption was indicated,and all 10 patients achieved good outcomes.Conclusion Most neonatal skull depression fractures lead to good outcomes through non-surgical treatment,which could avoid the trauma risk of surgery and anesthesia.

关 键 词：颅骨骨折 婴儿 新生 复位术 治疗结果 

分 类 号：R722.1[医药卫生—儿科]