累及静脉窦的颅骨凹陷性骨折的处理

Management of depressed skull fractures involving venous sinuses

目的探讨累及静脉窦的颅骨凹陷性骨折的临床特点、诊断及治疗。方法回顾性分析我院自2002年以来收治的57例伴有静脉窦损伤的凹陷性骨折病例的临床特征、诊断方法、治疗及预后情况。结果保守治疗11例,其中仅2例出现感染;手术治疗46例,其中3例为保守治疗出院后因颅内高压症状而再次入院者。本组治愈54例,死亡3例,死亡率为5.2%。结论保守治疗适用于无脑受压征及感染率小的患者,手术处理伤及静脉窦的颅骨凹陷性骨折应十分谨慎,对不同情况的凹陷性骨折及静脉窦损伤采取相应的治疗手段。

Objective To explore the elinieal eharaeters,diagnosis and treatment of depressed skull fraetures involving venous sinuses. Methods The characters, diagnosis, treatment and prognosis of 57 eases of depressed skull fraetures involving venous sinuses admitted since 2002 in our hospital were analyzed retrospectively, Results In Ihe eonservalive treatntenl group 2 out of II eases developed sepsis. Operations were performed in 46 eases. Fifty-four cases were eured,and 3 eases died（5.2% ）. Conclusion The eonservative therapy was indieated in those patieuts with no brain compressing sign and a little ehanee of getting infection. Preeaution should be kept in the management of depressed skull fraelures involving venous sinuses, Different treatment methods can be used according to the different eireumstanees of the injury of venous sinuses and depressed skull fractures.