人造材料在标准外伤大骨瓣减压中的应用分析

Artificial materials in the standard large trauma decompression

背景:硬脑膜修补材料对于恢复硬脑膜的解剖完整性非常必要,临床上应用广泛的材料是人造材料脑膜建。目的:探讨标准外伤大骨瓣减压术中应用脑膜建修复硬脑膜及硬脑膜敞开对患者的预后及二期颅骨修补的影响。方法:回顾分析重度颅脑损伤220例行标准外伤大骨瓣减压以及行颅骨修补93例的非同期对照临床资料,2004-12以前为硬脑膜敞开组,2005-01以后为人造材料脑膜建修补组。结果与结论:硬脑膜敞开组108例,发生颅内感染3例,癫痫11例,硬膜下积液12例,脑脊液漏7例,脑膨出18例,二期颅骨修补44例,人造材料修补组112例,发生颅内感染1例,癫痫5例,硬膜下积液4例,脑脊液漏2例,脑膨出7例,二期颅骨修补49例。标准外伤大骨瓣减压+人造材料修补硬脑膜可以明显降低患者的并发症的发生率和二期颅骨修补的概率。

BACKGROUND：Dural repair material for the anatomic integrity of the dura mater is necessary,and the dural repair materials in clinic are artificial menigeal tendon. OBJECTIVE：To investigate the effect of menigeal tendon for dura mater repair and dura mater opening on the prognosis and secondary cranioplasty during standard large trauma decompression. METHODS：Retrospective analysis was conducted in 220 patients with severe traumatic brain injury undergoing standard large trauma decompression and 93 patients undergoing cranioplasty. Patients admitted before 2004-12 were selected as dura mater opening group,and those after 2005-01 as menigeal tendon group. RESULTS AND CONCLUSION：Among 108 cases in the dura mater opening group,there were 3 cases of intracranial infection,11 of epilepsy,12 of subdural effusion,7 of cerebrospinal fluid leakage,18 of encephalocele,44 cases of secondary cranioplasty. In the menigeal tendon group,there were 1 case of intracranial infection,5 of epilepsy,4 of subdural effusion,2 of cerebrospinal fluid leakage,7 of encephalocele,49 cases of secondary cranioplasty. Standard large trauma decompression plus menipeal tendon repair can dramatically reduce the occurrence of complications and secondary cranioplasty rate.