带蒂颞深筋膜瓣修复大骨瓣减压术中硬脑膜缺损88例临床分析

Clinical analysis(88 cases) of pedicle deep temporal fascia repair drual defect in the standard large trauma craniotomy

目的 探讨不同方法标准脑外伤大骨瓣减压术的临床疗效。方法 对我科2002 年10 月至2004年7月间收治的GCS≤8分的重型颅脑创伤88例,随机分为研究组56 例,采用标准脑外伤大骨瓣减压术和带蒂颞深筋膜瓣修复硬脑膜缺损,对照组32例,单纯采用标准脑外伤大骨瓣减压术。结果 研究组术后脑脊液切口漏、皮下积液、感染、脑嵌顿和癫痫等的发生率明显低于对照组,而临床疗效显著优于对照组,经统计学分析两组差异有显著意义(P<0.05)和极显著意义(P<0.01)。结论 带蒂颞深筋膜瓣修复硬脑膜缺损在标准脑外伤大骨瓣减压术中应用,对于防止和降低术后各种并发症的发生率,提高重型颅脑损伤的治愈率,降低死亡率和致残率有着重要的临床应用意义。

Objective To explore clinical effect in two methods of the standard large trauma craniotomy.Methods We select 88 patients with severe craniocerebral trauma,they were divide into two groups randomly,study-group(56 cases) used the standard large trauma craniotomy and pedicle deep temporal fascia repair,control-group(32 cases) only used the standard large trauma craniotomy.Results The currence of leakage of cerebrospinal fluid,subcutaneous dropsy,infection,brain incarceration,epilepsy in study-group is less than that in control-group,while the clinical effect is better than that in control-group,they have obvius statistical difference(P<0.05).Conclusion In the standard large trauma craniotomy,pedicle deep temporal fascia repair drual defect can avoid varius complications,increase cure rate,decrease mortality rate and disabling rate.