改良式翻皮技巧对颞肌下颅骨修补术中颞肌功能的保护作用  

Protective effect of modified skin flap technique on temporal muscle function during the subtemporal cranioplasty

作　　者：王鹏 王志明 刘福增 殷尚炯 刘丽娜 WANG Peng;WANG Zhi-ming;LIU Fu-zeng;YIN Shang-jiong;LIU Li-na(Department of Neurosurgery,Hospital of Army 81st Group Military,Zhangjiakou Hebei 075000,China)

机构地区：[1]陆军第八十一集团军医院神经外科,河北张家口075000

出　　处：《局解手术学杂志》2021年第7期612-615,共4页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨改良式翻皮技巧对颞肌下颅骨修补术中颞肌功能的保护作用。方法回顾性分析45例采用改良式翻皮技巧颞肌下颅骨修补术的额颞顶部颅骨缺失患者(改良组)的临床资料,另选择45例采用常规颞肌下颅骨修补术的额颞顶部颅骨缺失患者(常规组)的临床资料,对2组患者手术时间、出血量、技术相关并发症(术中硬膜破损、颞肌及脑组织损伤等)、术后外观缺陷(额纹消失、颞肌萎缩及皮肤凹陷等)及主观舒适度(颞部疼痛、咀嚼无力等)进行比较。结果在手术时间、出血量方面,2组患者比较差异无统计学意义(P>0.05);在技术相关并发症方面,改良组并发症发生率低于常规组,差异有统计学意义(P<0.05);术后1个月行颞肌功能锻炼,术后随访3~6个月,改良组在恢复颞肌的外观、提高主观舒适度方面效果优于常规组,2组比较差异有统计学意义(P<0.05)。结论颞肌下颅骨修补术中采用改良式翻皮技巧可使颞肌的神经、血管及形态得到充分保留,减少对硬脑膜、脑组织的损伤,有助于术后颞部外形美观、颞肌功能的恢复。Objective To investigate the protective effect of modified skin flap technique on temporal muscle function during the subtemporal cranioplasty.Methods The clinical data of 45 patients with frontotemporal parietal cranial defect who underwent subtemporal cranioplasty with modified skin flap technique(modified group)were retrospectively analyzed.And the clinical data of another 45 patients with frontotemporal parietal cranial defect who were treated with conventional subtemporal cranioplasty(conventional group)were selected.The operation time,blood loss,technology related complications(dural damage,temporal muscle and brain tissue injury,etc.),postoperative appearance defects(frontal stria disappearance,temporal muscle atrophy and skin depression,etc.)and subjective comfort feelings(temporal pain,masticatory weakness,etc.)of the two groups were compared.Results There was no significant difference in operation time or blood loss between the two groups(P>0.05).In terms of technology related complications,the incidence of complications in the modified group was lower than that in the conventional group,and the difference was statistically significant(P<0.05).Temporal muscle function exercise was performed 1 month after surgery.The patients were followed up for 3 months to 6 months.The modified group had better effect on restoring the appearance of temporal muscle and improving the subjective comfort feelings,and the difference between the two groups was statistically significant(P<0.05).Conclusion The modified skin flap technique can fully preserve the nerves,blood vessels and morphology of temporal muscle in the subtemporal cranioplasty,and it can reduce the damage to dura mater and brain tissue,and help to restore the appearance and function of temporal muscle.

关 键 词：颞肌下颅骨修补 翻皮技巧 颞肌功能 颅骨缺失 并发症 

分 类 号：R743.34[医药卫生—神经病学与精神病学]