胶原海绵人工硬脑膜在颅脑损伤硬脑膜修补术中的临床应用

Clinical application of collagen sponge artificial dura mater in the repair of dural defects in patients with traumatic brain injury

目的 观察与评价胶原海绵人工硬脑膜在开颅术中硬脑膜修补的应用价值.方法 选取55例颅脑损伤手术需行硬脑膜修补病例,随机分为人工脑膜修补组（试验组）与自体膜修补组（对照组）,对2组术后一般情况、术后并发症的发生率及二期颅骨修补术中相关指标进行分析.结果 2组术后颅内感染及脑膨出发生率差异无统计学意义（P＞0.05）;试验组术后皮下积液及癫痫发生率低于对照组（P＜0.05）.试验组二期颅骨修补术中分离皮瓣出血量、手术时间均低于对照组（P＜0.01）;2组术后硬脑膜外总引流量差异无统计学意义（P＞0.05）.结论 胶原海绵人工硬脑膜使用安全、简便,是开颅手术中硬脑膜修补较为理想的材料.

Objective To investigate and analyze the clinical data regarding the application of collagen sponge in dural repairing of patients with traumatic brain injury. Methods Fifty - five patients with traumatic brain injury who needed repair of dural defects were randomly divided into collagen sponge artificial dura mater group （test group） and autologous fascia group （ control group）. The general status after operation, rate of postoperative complication and parame ters related to the stage two cranioplasty between the two groups were compared. Results There were no significant differences in the rate of postoperative infection and cephalocele between the two groups （ P 〉 0.05 ）. The rate of postop- erative subcutaneous cerebrospinal fluid leakage and epilepsy in the test group was significantly less than that in the con trol group （ P 〈 0.05 ）. In the stage two cranioplasty, the bleeding volume and operating time in the test group were sig- nificantly less than those in the control group （ P 〈0.01 ）. No statistical significant difference in the total epidural drainage volume of was observed （P 〉 0.05 ）. Conclusion Collagen sponge artificial dura mater is safe and convenient for the repair of dural defects in patients with traumatic brain injury.