中颅底骨折相关并发症的临床分析

摘要

目的 探讨中颅底骨折及相关并发症的临床特点及治疗经验. 方法 本组61例中颅底骨折患者中伴有脑脊液漏的患者41例,除1例采用开颅修补硬脑膜,其余采用保守治疗;相关脑神经损伤31例,对于伤后即刻出现的面瘫,早期采用面神经管减压;颈内动脉海绵窦漏( CCF ) 3例,采取介入手术治疗. 结果脑脊液漏患者均得到治愈,脑神经损伤患者有不同程度的好转,CCF患者均治愈;死亡2例. 结论 绝大多数中颅底骨折致脑脊液漏患者通过保守治疗能得到治愈,不需要开颅修补硬脑膜;对于伤后立即出现的面瘫,根据薄层CT扫描确定损伤部位,早期面神经管减压有助于面神经恢复;早期发现CCF并及时处理对患者病情恢复有重要意义.%Objective To explore the clinical characteristics and treatment experience on related complication of middle skull base fracture .Methods Of 61 patients with middle skull base fracture , there were 41 cases with cerebrospinal fluid leakage ,31 cranial nerve injury and 3 carotid cavernous fistula(CCF).These patients were underwent conservative treatment ,surgical treatment or interven-tional methods .Results patients with cerebrospinal fluid leakage and CCF were cured ,patients with cranial nerve injury got better and 2 died.Conclusions The vast majority cases of cerebrospinal fluid leakage through conservative treatment can be cured .For facial paralysis appeared immediately after injury ,according to the thin layer CT scan to determine injury site , facial nerve canal decompression is helpful to facial nerve recovery .Early detection CCF is important for patients to rehabilitation .