头皮冠状切口的并发症及其防治

Prevention and Treatment of Complications of Scalp Coronal Incision

目的：对采用头皮冠状切口所引发的并发症进行分析，探讨防治策略。方法：对我科2003-01～2006—07应用头皮冠状切口行颅颌面骨折修复重建、颌面部肿瘤切除与缺损修复、先天性颅颌面畸形矫正的221例中发生并发症的40例进行分析总结。结果：18例出现头皮麻木及感觉异常，9例有较宽切口瘢痕，6例出现脱发，4例发生颞窝凹陷，2例发生头皮下血肿，2例出现单侧面神经颞支损伤，1例发生鼻眶区肥厚。结论：头皮冠状切口具有切口隐蔽、面部疤痕不明显，显露充分的优点，但对其并发症也不容忽视。应根据具体情况选择合适的切口类型，术中精细的解剖、神经血管的良好保护以及正确的缝合方法可减少并发症的发生。

Objective：To analyze the complications of scalp coronal incision and study the effective methods of prevention. Methods ：The investigation and summaries were based on 221 cases ,who applied scalp coronal incision from 2003 to 2006 for craniofacial fracture＇s reconstruction,maxillofacial tumor＇s excision,congenital craniofacial malformation＇s remedy. Results ：There were scalp numbness and paraesthesia in 18 cases ,incision scar in 9 cases ,alopecia in 6 cases, temporal fossa introcession in 4 cases,subcutaneous hematoma in 2 cases ,injury of unilateral temple branch of the facial nerve in 2 cases and naso-orbital pachynsis in 1 case. Conclusion ：The scalp coronal incision has the merits of hidden incision, indistinct scar and enough exposure ,but its complications can not be neglected. We may reduce the incidence of postoperative complications through intraoperative meticulous dissection,protecting the nerve and blood vessel well, choosing the appropriate incision and correct suture.