带蒂颞深筋膜瓣修复大骨瓣减压术中硬脑膜缺损88例临床分析

目的　探讨不同方法标准脑外伤大骨瓣减压术的临床疗效。方法　对我科2002 年10 月至2004年7月间收治的GCS≤8分的重型颅脑创伤88例,随机分为研究组56 例,采用标准脑外伤大骨瓣减压术和带蒂颞深筋膜瓣修复硬脑膜缺损,对照组32例,单纯采用标准脑外伤大骨瓣减压术。结果　研究组术后脑脊液切口漏、皮下积液、感染、脑嵌顿和癫痫等的发生率明显低于对照组,而临床疗效显著优于对照组,经统计学分析两组差异有显著意义(P<0.05)和极显著意义(P<0.01)。结论　带蒂颞深筋膜瓣修复硬脑膜缺损在标准脑外伤大骨瓣减压术中应用,对于防止和降低术后各种并发症的发生率,提高重型颅脑损伤的治愈率,降低死亡率和致残率有着重要的临床应用意义。

Clinical analysis(88 cases) of pedicle deep temporal fascia repair drual defect in the standard large trauma craniotomy

Objective To explore clinical effect in two methods of the standard large trauma craniotomy.Methods We select 88 patients with severe craniocerebral trauma,they were divide into two groups randomly,study-group(56 cases) used the standard large trauma craniotomy and pedicle deep temporal fascia repair,control-group(32 cases) only used the standard large trauma craniotomy.Results The currence of leakage of cerebrospinal fluid,subcutaneous dropsy,infection,brain incarceration,epilepsy in study-group is less than that in control-group,while the clinical effect is better than that in control-group,they have obvius statistical difference(P<0.05).Conclusion In the standard large trauma craniotomy,pedicle deep temporal fascia repair drual defect can avoid varius complications,increase cure rate,decrease mortality rate and disabling rate.