成人颅骨修补术后并发症及其防治策略

Postoperative complications and treatment strategies after cranioplasty in adults

目的分析成人颅骨修补术后并发症的类型及其防治策略。方法回顾性分析联勤保障部队第九四〇医院神经外科自2017年1月至2022年2月行颅骨修补术后发生并发症的40例患者的临床资料,研究颅骨修补术后并发症的类型及原因,结合相关文献分析探讨诊疗策略。结果颅骨修补术后,8例患者发生硬膜外血肿,1例患者发生脑挫裂伤并血肿,9例患者发生感染,2例患者随访发生局部颞肌的萎缩,4例患者随访发生感染修补材料外露,15例患者发生癫痫,临床给予相应治疗后均治愈出院,其中1例患者发生反常性脑疝死亡。结论颅骨修补术后并发症包括皮肤及皮下感染、修补材料外露、颅内出血、癫痫、反常性脑疝等,临床医生需要制订个性化的诊疗策略,以降低修补术后并发症的发生率。

Objective To analyze the types of complications after cranioplasty in adults and their prevention and treatment strategies.Methods The clinical data of 40 patients with complications after cranioplasty in Neurosurgery Department of the 940^(th) Hospital of Joint Logistics Support Force of PLA from January 2017 to February 2022 were retrospectively analyzed.The types and causes of complications after cranioplasty were analyzed,and the diagnosis and treatment strategies were discussed based on the analysis of relevant literature.Results After cranioplasty,epidural hematoma occurred in 8 patients,cerebral contusion and hematoma occurred in 1 patient,infection occurred in 9 patients,atrophy of local temporalis muscle occurred in 2 patients,exposure of infected repair material occurred in 4 patients,epilepsy occurred in 15 patients after surgery.After receiving corresponding clinical treatment,all patients were cured and discharged.Among them,1 patient died of paradoxical brain herniation after surgery.Conclusion The postoperative complications of cranial repair include skin and subcutaneous infection,exposure of repair material,intracranial hemorrhage,epilepsy,and paradoxical brain herniation,etc.Clinicians need to develop individualized treatment strategies to reduce the incidence of postoperative complications.