股部保存骨瓣阔筋膜扩大修补硬膜治疗重型颅脑损伤的效果

TREATMENT OF SEVERE HEAD INJURY WITH FASCIA LATA FEMORIS AND CONSERVATION OF BONE FLAP IN THE THIGH

目的探讨应用股部保存骨瓣阔筋膜扩大修补硬膜治疗重型颅脑损伤的效果。方法对52例重型颅脑损伤病人行去骨瓣减压术,并于股外侧切口取阔筋膜扩大修补硬脑膜,同时将骨瓣包埋于股外侧切口内,条件许可则早期行骨瓣复位。结果52例病人中恢复良好者占72%,轻残者占18%;除2例第一次术后并发颅内感染,5例颅骨修补术后出现小量皮下积液外,其余病人均未发生其他严重并发症。结论采用股部保存骨瓣阔筋膜扩大修补硬膜治疗重型颅脑损伤,操作简单,手术创伤小,能有效减少各种并发症,提高救治成功率,且不需特殊设备,可在条件相对较差的基层医院开展。

Objective To explore the treatment of severe head injury with conservation of bone flap in the thigh and repair of meninx fibrosa with fascia lata femoris. Methods Fifty-two patients were treated by decompressive craniotomy. A piece of fascia lata femoris was harvested from the lateral side of the thigh for duraplasty. The bone flap was preserved within the incision of the thigh. Repositioning of the bone flap would be done early when conditions permitted. Results Of the 52 patients, 72% recovered well, 18% had moderate disability. Two had intracranial infection and five developed subdermal hydrops. Conclusion Treatment of severe head injury with the technique used in this study is simple and convenient, with less complications, which is recommended to be carried out at basic level hospitals.