创伤性前颅底粉碎性骨折合并颅底硬脑膜破损颅底膜性重建

摘要

Objective To analyse the clinical features of the dura bone defect repair of the former skull base comminuted fracture and the dura mater of the skull base damage. Methods 27 patients who had been treated in our hospital from May 2005 to March 2014 for the former skull base comminuted fracture and the dura mater of the skull base damage were selected as research objects. Clinical data, therapeutic method and follow-up results were retrospective analysed. Results 2 patients occurred cerebrospinal fiuid rhinorrhea, and were relieved after conservative medical therapy. 24 patients were conscious, 1 patient died after surgery, and 2 became human vegetable. Conclusion The dura bone defect repair on patients with former skull base comminuted fracture and the dura mater of the skull base damage is important. It is worth of being popularized clinically.%目的：探讨创伤性前颅底粉碎性骨折合并颅底硬脑膜破损的临床特点，并对治疗方法进行分析。方法回顾性分析2005年5月～2014年3月的27例创伤性前颅底粉碎性骨折合并颅底硬脑膜破损的临床资料、治疗方法及随访结果。结果25例术后近期未发现脑脊液瘘，2例术后早期有脑脊液鼻漏，经腰大池置管等…保守治疗，脑脊液漏停止。24例神志清醒，1例因多脏器功能衰竭，于术后2月死亡，2例术后呈植物生存状态。结论对前颅底粉碎性骨折合并颅底硬脑膜破损手术治疗的关键是一定要行颅底膜性重建，对脑脊液漏及时、恰当的处理，并做好脑部清创，清除可能引起颅内感染的因素，同时要兼顾功能与整容…的目的。