颅脑创伤手术中人工硬脑膜的应用临床分析

The application of artificial dura mater in brain trauma surgery

目的:探讨颅脑创伤手术中人工硬脑膜的应用价值。方法:将我院2009年8月至2012年4月收治的颅脑创伤患者100例随机分为对照组与观察组各50例。对照组采用生物人工脑膜进行硬膜缺损修补,观察组采用人工硬脑膜进行硬膜缺损修补。观察对比两组患者的GCS评分及并发症,同时对住院时间及费用进行统计比较。结果:治疗前两组患者的GCS评分无明显区别。治疗后,观察组患者GCS评分为(12.28±0.10)分,明显高于对照组[(9.06±0.80)分](P<0.01);术后对患者进行头颅CT检查,观察组患者脑组织外露发生率2%,颅内感染发生率4%,顽固性脑膨出发生率2%,硬膜下积液发生率4%,癫痫发生率2%,除癫痫外均分别低于对照组;观察组的住院时间及费用均明显低于对照组,以上指标两组比较差异具有统计学意义(P<0.05或<0.01)。结论:颅脑创伤手术中采用人工硬脑膜进行硬膜缺损修补疗效显著,能够显著降低各种并发症的发生率,有效防止病情进一步发展,减轻患者的经济负担,值得临床推广应用。

Objective ：To investigate the application value of artificial dura mater in brain trauma surgery. Methods ：100 patients with traumat- ic brain injury in hospital from August 2009 to April 2012 were randomly divided into the control group（50 cases） and the observation group（50 cases）. The control group was given biological artificial meningeal, and the observation group was given artificial dura mater. The two groups were compared in pa- tients with GCS score, complications, hospitalization time and costs. Results：Before treatment, the GCS score of two groups was no significant difference. After treatment,GCS score of patients in the control group [ （ 12.28 ±0.01 ） points] was significantly higher than that in the control group[ （9.06 ±0.08 ） points ] （ P 〈 0.05 ） ; postoperative patients with head CT scan, the observation group were exposed brain tissue of incidence of 2%, intracranial infection incidence rate was 4%, refractory encephalocele incidence of 2% ,subdural effusion incidence of 4% ,epilepsy incidence of 2%, in addition to epilepsy, all were lower than those of control group ; hospitalization time and cost of the observation group were significantly lower than the control group, the above indicators the difference was statistically significant （ P 〈 0.05 or 〈 0.01 ）. Conclusion： The use of artificial dura mater surgery of traumatic brain injury conducted the dural defect effect is significant, can significantly reduce the incidence of various complications, effectively preventing the fur- ther development of the disease, reduce the economic burden of patients, is worthy of clinical application.