游离阔筋膜用于开颅术后顽固颅内感染硬脑膜修复重建  

Application of free fascia lata for dura mater reconstruction in the treatment of the refractory intracranial infection after craniotomy

作　　者：殷林华 王明圣 章峰 徐子军 曾涛 YIN Linhua;WANG Mingsheng;ZHANG Feng;XU Zijun;ZENG Tao(Department of Neurosurgery,Shanghai Tenth People’s Hospital,Shanghai 200072,China)

机构地区：[1]张家港第二人民医院神经外科,张家港215600 [2]同济大学附属上海市第十人民医院神经外科 [3]同济大学附属上海市第十人民医院放射科

出　　处：《中国神经精神疾病杂志》2024年第11期650-654,共5页Chinese Journal of Nervous and Mental Diseases

摘　　要：目的总结游离阔筋膜在开颅术后顽固性颅内感染患者重建手术中的应用。方法回顾分析采用游离阔筋膜进行硬脑膜修复重建的方法治疗开颅术后顽固性颅内感染22例患者的临床资料、治疗结果及随访的情况。结果22例患者通过彻底清创,清除感染组织,去除人工脑膜等,均使用游离自体阔筋膜进行硬脑膜的修复重建。21例患者感染获治愈,3例患者术后因其他并发症于院内死亡,其中1例重建术后1周因大量脑出血死亡时感染未治愈。存活患者随访13~86个月,均无感染复发。结论使用游离的阔筋膜重建硬脑膜,对耐药菌感染所致的复杂颅内感染,仍是一种有效且相对简单易行的方法。Objective To summarize the application of free fascia lata in reconstructive surgery for patients with refractory intracranial infection after craniotomy.Methods A retrospective analysis was performed for the clinical data,treatment details,results,and follow-up of 22 patients with refractory intracranial infection caused by drug-resistant bacteria treated with free fascia lata.Results Twenty-two patients were included in the cohort.All these patients underwent salvage surgery,including removal of the artificial alien dura mater and achievement of complete dura seal with free fascia lata.Immediate infection curation was achieved in 21 patients.In-hospital death occurred in 3 patients with other complications,of them,a patient whose infection curation was not achieved when he died from massive intracerebral hemorrhage 1 week after reconstruction surgery.During a period of 13-86 month follow-up,the surviving patients remained free of infection recurrence.Conclusion Free fascia lata repair can serve as a more straightforward but effective option for dura mater reconstruction,even in the setting of a severe septic area caused by multiple drug-resistant bacteria.

关 键 词：颅内感染 手术部位感染 多重耐药菌 阔筋膜 重建 硬脑膜 

分 类 号：R651.1[医药卫生—外科学]