颅骨骨膜减张修补硬脑膜在急性小脑幕切迹疝去骨瓣减压手术中的应用

The clinical experience in using duramater tension-reduced suture pericranium in decompressive hemicraniectomy of acute transtentorial herniation

目的分析比较急性小脑幕切迹疝去骨瓣减压手术中,颅骨骨膜瓣减张修补硬脑膜与常规缝合硬脑膜的临床疗效。方法回顾性统计分析2016年1月份~2017年6月份我院急性小脑幕切迹疝去骨瓣减压手术患者的预后,采用曼-惠特尼U检验(Mann-Whitney U test)分析颅骨骨膜瓣减张修补硬脑膜(观察组,n=26)与常规缝合硬脑膜(对照组,n=241)两组患者GOS的差异。结果两组组患者GOS比较,U检验发现硬脑膜减张缝合组(观察组)的GOS与对照组之间的差异具有统计学意义(P<0.05)。结论硬脑膜减张缝合组的患者预后明显优于常规缝合组,并发症明显小于对照组。

Objective To compare the clinical effects of two surgical procedures between duramater tension-reduced suture using pericranium and traditional dura mater suture in decompressive hemicraniectomy of acute transtentorial herniation. Methods From January 2016 to June 2017,a retrospective analysis was performed on the prognosis of patients with decompressive hemicraniectomy of acute transtentorial herniation. Mann-Whitney U test was used to analyze the GOS difference between dura mater tension-reduced suture using pericranium and traditional dura mater suture. Results When compared with traditional dura mater suture（control group,n=24）,the patients underwent dura mater tension-reduced suture using pericranium（observation group,n=26）showed lower GOS scores（P〈0.05）. Conclusion Dura mater tension-reduced suture was superior to traditional dura mater suture in prognosis and reducing the occurrence of complications and should be generalized.