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中国临床研究英文版:2018,31(3):359-361
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人工硬脑膜减张缝合术在颅骨修补术中的疗效
(1.广州中医药大学附属研究生院,广东 广州 510006;2.中山市中医院外四科,广东 中山 528400)
Effect of artificial dura mater tension-reduced suture in cranioplasty
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Received:August 22, 2017   Published Online:March 20, 2018
中文摘要: 目的 探讨人工硬脑膜减张缝合术在重型闭合性颅脑损伤患者二期颅骨修补术中的应用价值。方法 回顾性分析173例重型闭合性颅脑损伤患者的临床资料,其中对照组92例采用常规剪开硬脑膜减压,治疗组81例采用人工脑膜减张缝合硬脑膜,两组患者均在一期手术后3个月行颅骨修补术,观察比较两组患者在颅骨修补的手术时间、术中发生蛛网膜破损情况、术后早期并发症发生情况。结果 治疗组术中蛛网膜破损发生率(3.7% vs 30.4%)和手术时间[(85.60±13.08)min vs (95.53±26.39)min]低于对照组,差异有统计学意义(P<0.01)。术后14d内,治疗组术后皮下积液、积血(3.7% vs 27.2%)和癫痫(3.7% vs 12.0%)的早期并发症发生率低于对照组,差异有统计学意义(P<0.05,P<0.01)。结论 使用人工硬脑膜在去骨瓣减压术中减张缝合硬脑膜对二期颅骨修补术后减少早期并发症的发生有一定的价值。
Abstract:Objective To investigate the application value of artificial dura mater tension-reduced suture in two-stage cranioplasty for patients with severe closed craniocerebral injury.? Methods A retrospective was performed on the clinical data of 173 patients with severe closed craniocerebral injury. There were 92 patients treated with conventional dural-cut decompression ( control group) and 81 patients treated with artificial dura tension-reduced suture(treatment group). Three months later, all patients underwent cranioplasty in that operation time, intraoperative arachnoid damage and early postoperative complications were observed and compared between two groups.? Results The incidence of arachnoid damage (3.7% vs 30.4%)and the operation time[(85.60±13.08)min vs(95.53±26.39)min] were significantly lower in treatment group than those in control group (all P<0.05). During 14 days after operation, the incidence rates of subcutaneous blood and effusion accumulation (3.7% vs 27.2%) and epilepsy (3.7% vs 12.0%) in treatment group were statistically lower than those in control group (P<0.05, P<0.01).? Conclusion The artificial dura mater tension-reduced suture has a certain value in reducing the occurrence of early postoperative complications in two-stage cranioplasty.
文章编号:     中图分类号:R 651.1+5    文献标志码:A
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