人工硬脑膜在硬膜下电极埋置术中的应用  

Application of artificial dura mateRin subdural electrode implantation

作　　者：张伟 夏毅 井晓荣 王超 ZHANG Wei;XIA Yi;JING Xiao-rong;WANG Chao(Department of Neurosurgery,Tangdu Hospital,AiRForce Medical University,Xi'an 710038,China)

机构地区：[1]空军军医大学唐都医院神经外科,西安710038

出　　处：《中国临床神经外科杂志》2024年第5期271-273,共3页Chinese Journal of Clinical Neurosurgery

基　　金：陕西省自然科学基础研究计划(2014JQ4132)。

摘　　要：目的探讨使用人工硬脑膜修补替代自体硬脑膜原位缝合在降低硬膜下电极埋置术后并发症发生率中的作用。方法回顾性分析2008年1月至2021年12月进行硬膜下电极埋置术的308例病人的临床资料。2008年1月至2013年12月手术的163例采取自体硬脑膜原位缝合(自体硬脑膜组),2014年1月至2021年12月手术的145例采取人工硬脑膜修补(人工硬脑膜组)。两组手术评估、手术操作均为同一治疗团队完成,除对硬脑膜处理方式改变之外,其余手术流程保持一致。结果自体硬脑膜组术后继发颅内出血13例(7.97%)、脑脊液漏22例(13.50%)、颅内感染5例(3.07%);人工硬脑膜组术后继发颅内出血4例(2.76%)、脑脊液漏7例(4.83%)、颅内感染3例(2.07%)。人工硬脑膜组术后继发性颅内出血发生率、脑脊液漏发生率均明显低于自体硬脑膜组(P<0.045)。两组术后颅内感染发生率无统计学差异(P>0.045)。结论在硬膜下电极埋置术中使用人工硬脑膜修补替代自体硬脑膜原位缝合,在降低继发颅内出血、脑脊液漏方面具有明显的优势。Objective To investigate the role of using artificial dura mateRpatch in replacing autologous dura mateRsuture in reducing the incidence of complications afteRplacement of subdural electrodes.Methods The clinical data of 308 patients who underwent subdural electrode implantation from January 2008 to DecembeR2021 were retrospectively analyzed.Of the 163 patients who underwent the operation from January 2008 to DecembeR2013,the autologous dura mateRwas sutured in situ(autologous dura mater group).Of the 145 patients who underwent the operation from January 2014 to DecembeR2021,artificial dura mateRpatch was used(artificial dura mateRgroup).The surgical evaluation and operation were performed by the same treatment team foRboth groups,and the surgical procedures were kept consistent except foRthe way of handling the dura mater.Results The rates of postoperative intracranial hemorrhage(7.97%)and cerebrospinal fluid leakage(13.50%)in the autologous dura mateRgroup were significantly higheRthan those(2.76%and 4.83%,respectively)in the artificial dura mateRgroup(P<0.045).There was no statistically significant difference in the incidence of postoperative intracranial infection(3.07%vs.2.07%)between the two groups(P>0.045).Conclusion The use of artificial dura mateRpatch in place of autologous dura mateRsuture in subdural electrode implantation can reduce the incidence of postoperative intracranial hemorrhage and cerebrospinal fluid leakage.

关 键 词：硬膜下电极埋置术 人工硬脑膜 自体硬脑膜 并发症 

分 类 号：R742.1[医药卫生—神经病学与精神病学] R651.11[医药卫生—临床医学]