弯组织剪与手术刀在颅骨修补术中分离颞肌皮瓣的对比研究

Comparative study of dissecting temporalis musculocutaneous flap with curved scissors and scalpel during cranioplasty

目的对比颅骨修补术中弯组织剪刀与手术刀分离颞肌皮瓣的效果。方法回顾性分析64例去骨瓣减压术后行颅骨修补手术病人的临床资料,分别采用手术刀(手术刀组,n=32)和弯组织剪刀(剪刀组,n=32)分离颞肌皮瓣。比较两组手术操作时间、失血量、术后引流量、术后并发症等指标。结果剪刀组手术操作时间(87.7±17.7)min,失血量(96.8±20.8)ml,术后引流量(161.1±33.1)ml;手术刀组手术操作时间(101.6±29.7)min,失血量(152.8±29.9)ml,术后引流量(148.1±37.3)ml;剪刀组手术操作时间和失血量均显著低于手术刀组(P<0.05),而两组术后引流量无明显差异(P>0.05);两组术后均未出现手术相关并发症。结论与手术刀相比,在颅骨修补时采用弯组织剪刀分离颞肌皮瓣具有创伤小、效率高的优势。

Objective To compare the results of dissecting temporalis musculocutaneous flap with curved scissor and scalpel during cranioplasty. Methods Clinical data of 64 patients undergoing cranioplasty after decompressive craniectomy were analyzed retrospectively. The patients were divided into the scalpel group and the scissor group according to the different methods for dissecting temporalis musculocutaneous flap. The operating time, bleeding volume, postoperative drainage volume and complications were recorded and compared between the groups. Results The operating time, bleeding volume and postoperative drainage volume were respectively 87.7±17.7 min, 96.8±20.8 ml and 161.1±33.1 ml in the scissor group, while 101.6±29.7 min, 152.8±29.9 ml and 148.1±37.3 ml in the scalpel group. The operating time and bleeding volume in the scissor group were obviously lower than those in the scalpel group(P < 0.05), while no significant difference in the postoperative drainage volume was found between the two groups(P >0.05). Otherwise, no complication occurred after the operation in the two groups. Conclusion Compared with scalpel, it has advantages of less trauma and higher efficiency to dissect the temporalis musculocutaneous flap with curved scissor during cranioplasty.