骨膜为蒂的颞深筋膜瓣在标准外伤性大骨瓣开颅硬脑膜减张缝合中的应用研究

Application of the deep temporal fascia flap pedicled with periosteum on traumatic standard large trauma craniotomy deompression

目的探讨骨膜为蒂的颞深筋膜瓣在标准外伤性大骨瓣开颅硬脑膜减张缝合中应用。方法分析研究重型颅脑损伤标准外伤性大骨瓣入路开颅的患者74例,分为人工脑膜组36例和骨膜为蒂的颞深筋膜组38例,2组均行开颅血肿清除术+去骨瓣减压术并减张缝合硬膜,观察术后的硬膜间积液等并发症和经济负担。结果骨膜为蒂的颞深筋膜组术后无并发症,经济负担轻,与对照组比较有统计学意义(P<0.01)。结论骨膜为蒂的颞深筋膜瓣在标准外伤性大骨瓣开颅硬脑膜减张缝合的手术操作方法可以安全应用,是对标准外伤性大骨瓣开颅术的重要补充。

Objective To explore the application of the deep temporal fascia flap pedicled with periosteum in traumatic standard large trauma craniotomy deompression.Methods 74 cases of severe traumatic brain injury treated with standard large trauma craniotomy were included,with 36 cases of artificial meningeal group and 38 cases of deep temporal fascia flap pedicled with periosteum group.The two groups were both treated by intracranial hematoma removal and decompressive craniectomy.The postoperative complications of effusion and the economic burden of the patients were observed.Results Compared with the control group,patients treated with deep temporal fascia flap pedicled with periosteum have no postoperative complications and lower economic burden（P〈0.01）.Conclusion The deep temporal fascia flap pedicled with periosteum on traumatic standard large trauma craniotomy decompression may be safely applied in the future as an important supplement to the traumatic standard large trauma craniotomy.