前额颅底开放性颅脑损伤的手术治疗

摘要

目的 探讨前额颅底开放性颅脑损伤尤其是颅底重建的手术方法.方法 收集21例前额部近颅底的开放性颅脑损伤患者的临床资料,通过分析影像资料,急诊手术行开颅探查.术中可以发现程度不同的颅底骨骨折,硬膜破损,以及脑组织的损伤和脑内血肿等.手术采用自体局部可设计利用的额颞肌,筋膜,骨膜组织进行重建颅底及修复破损硬膜.结果 术后无脑脊液漏,无颅内感染等并发症.结论 在彻底的颅脑清创的基础上,采用带蒂自体额颞肌筋膜骨膜瓣可以有效修复开放性损伤的颅底,临床手术效果良好,并发症低.%Objective To summarize surgical repair for the open craniocerebral injury complicating with forehead and skull base fractures.Methods The clinical data of 21 patients with open craniocerebral injury complicating with forehead and skull base fractures underwent emergent operation were analyzed retrospectively.We discovered skull base fractures,dura mater damages and brain tissue injury with different level during operation.The operation were performed using the patient's own frontal temporal muscle,anadesma,periosteum and other tissue for reconstruction.Results No complications,such as intracranial infection and cerebrospinal fluid leakage occurred.Conclusion On the basis of completely debridement,used the patient's own frontal temporal muscle,anadesma,periosteum and other tissue for reconstruction could effective repair broken skull bas V-Pe and reduce complications.