颅表定位器在硬膜外血肿治疗中的应用

Skull positioning device in the treatment of epidural hematoma

目的 探讨颅表定位器在硬膜外血肿治疗中的应用价值.方法 对病情相对稳定,出血量在20～65 ml之间的幕上硬膜外血肿患者,术前戴颅表定位器行颅脑CT扫描,绘出硬膜外血肿的颅表投影,术前设计较小的手术切口和颅骨瓣;术中清除血肿、有效止血;骨瓣复位颅骨锁固定.结果 定位器定位的血肿位置与术中所见血肿实际位置误差小于3 mm,手术切口及骨瓣明显小于传统骨瓣开颅手术,血肿清除率均达90%以上.结论 颅表定位器的准确定位,使手术每一步骤更合理,以较小的创伤达到较佳治疗目的,应在临床推广应用.

Objective To study the clinical value of the skull positioning device in the treatment of epidural hematoma. Method Patients, whose conditions were relatively stable, and the supratentorial epidural hematoma were between 20 ～ 65 ml, were put the locator on before head CT scan. According to the results, we drew projections of the hematoma on their heads surface, and designed smaller incisions and bone flaps before operations. During operations, we removed the hematoma clearly, and stopped bleeding effectively, replace bone flap and fix it with crania fixation system. Result The error between projection positions and actual positions are less than 3mm. The operative incisions and the bone flaps are much smaller than traditional surgery. The hematoma clearance rate is over 90%.Conclusion The accurate positioning makes each step of surgery more reasonable. It helps us to get better therapeutic effeet with less lesion. It should be popularized and applied in clinic.