颅骨修补术中应用单极电凝和手术刀片分离颞肌皮瓣的效果比较  

Comparison of the effects of unipolar electrocoagulation and surgical blade on separating temporal musculocutaneous flap in cranioplasty

作　　者：朱留鑫[1] 司东明[1] 杨建[1] Zhu Liuxin;Si Dongming;Yang Jian(Department of Neurosurgery,the First Afiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450099,China)

机构地区：[1]河南中医药大学第一附属医院神经外科,郑州450099

出　　处：《临床医学》2023年第5期10-13,共4页Clinical Medicine

摘　　要：目的 比较颅骨修补手术中应用单极电凝和手术刀片分离颞肌皮瓣的效果。方法 采用回顾性研究的方法,收集2015年1月至2022年3月河南中医药大学第一附属医院神经外科收治的98例去骨瓣减压术后使用钛网行颅骨修补手术患者的临床资料,分别使用单极电凝(研究组,n=48)与手术刀片(对照组,n=50)分离颞肌皮瓣,比较两组患者的手术时间、术中出血量、硬脑膜破损率、术后48 h引流量,以及术后硬膜外血肿、二次手术、皮下积液、皮瓣或切口愈合不佳、感染、癫痫等并发症发生率。结果 与对照组比较,研究组手术时间显著缩短、术中出血量显著减少,差异有统计学意义(P<0.05)。硬脑膜破损率、术后48 h引流量及术后并发症发生率比较,差异未见统计学意义(P>0.05)。结论 颅骨修补术中应用单极电凝可缩短手术时间,减少术中出血量,使手术视野更加清晰,而且不增加硬膜外血肿、二次手术、皮下积液、皮瓣或切口愈合不佳、感染、癫痫等并发症的发生率。颅骨修补术中使用单极电凝分离颞肌皮瓣操作简便,安全可靠。Objective To compare the effects of unipolar electrocoagulation and surgical blade on separating temporal musculocutaneous flap on cranioplasty.Methods Using the method of retrospective study,the clinical data of 98 patients who underwent cranioplasty with titanium mesh after decompressive craniectomy were collected from January 2015 to March 2022 in the Department of Neurosurgery,the First Affiliated Hospital of Henan University of Traditional Chinese Medicine,the temporal musculocutaneous flaps were separated by unipolar electrocoagulation(study group,n=48) and surgical blade(control group,n=50).The operation time,blood loss during operation,dura mater rupture rate and drainage volume 48 hours after operation were compared between the two groups,and the complications such as postoperative epidural hematoma,secondary surgery,subcutaneous effusion,flap or incision healing failure,infection,epilepsy were compared.Results Compared with the control group,the operation time and intraoperative blood loss of the study group were significantly lower,and the differences were significant(P<0.05).There were no significant differences in the rate of dural damage,drainage volume at 48h after surgery and postoperative complications(P>0.05).Conclusions The application of unipolar electrocoagulation in cranioplasty can shorten the operation time,reduce intraoperative blood loss and make the surgical field more clear,without increasing the incidences of epidural hematoma,secondary operation,subcutaneous effusion,poor healing of flap or incision,infection,epilepsy and other complications.The use of unipolar electrocoagulation to separate temporal musculocutaneous flap in skull repair is simple,reliable and safe.

关 键 词：颅骨修补术 单极电凝 手术刀片 

分 类 号：R651.1[医药卫生—外科学]