新生儿颅骨骨折22例分析

An analysis of 22 cases with neonatal skull fracture

目的分析新生儿颅骨骨折的治疗及预后。方法回顾性分析新生儿颅骨骨折22例的临床资料。结果 22例中,颞骨骨折12例,枕骨骨折5例,顶骨骨折10例;线性骨折15例,凹陷性骨折7例。伴有硬膜外血肿4例,硬膜下血肿3例,蛛网膜下腔出血13例。15例线性骨折患儿中,1例行硬膜外血肿清除术+骨折复位术,其余保守治疗。7例凹陷性骨折患儿中,2例行颅骨撬起手术复位治疗,其余均保守治疗。手术治疗的患儿后期复查头颅影像学基本恢复正常;保守治疗的患儿随访无神经系统后遗症,生长发育良好。结论未合并颅内出血的新生儿颅骨线性骨折仅需保守治疗;凹陷性骨折通过非手术治疗亦可达到良好的临床效果。

Objective To analyze the treatment and prognosis of neonatal skull fracture.Methods The clinical data of 22 cases with neonatal skull fracture were retrospectively analyzed.Results Of 22 cases, 12 cases were with temporal bone fracture, 5 cases were with occipital bone fracture and 10 cases were with parietal bone fracture.Fifteen cases were with linear skull fracture and 7 cases were with skull depressed fracture.There were 4 cases with epidural hematoma, 3 cases with subdural hematoma and 13 cases with subarachnoid hemorrhage.Of 15 cases with linear fracture, one case received a surgery for epidural hematoma removal plus fracture reduction and others were treated conservatively.Of 7 cases with skull depressed fracture, 2 cases were treated with cranial prying operation for reduction and others were treated conservatively.The postoperative cranial imaging examination showed satisfactory recovery in the neonates underwent surgical treatment.No neurological sequelae happened and the growth and development were well in the neonates treated conservatively.Conclusion Only conservative treatment is needed in the neonates with linear skull fracture without intracranial hemorrhage.The depressed fracture can achieve good clinical results through non-surgical treatment.