神经补片在去骨瓣减压术中的作用

目的探讨神经补片在去骨瓣减压术中的作用。方法回顾性研究,治疗组的78例患者在标准去骨瓣减压时使用神经补片修补硬脑膜,对照组的36例患者在标准去骨瓣减压时使用自体筋膜修补硬脑膜。术后对比两组患者的癫痫发生率;在二期的修补治疗中对比两组患者的手术时间、术中出血量及硬脑膜破损率。结果治疗组和对照组的癫痫发生率分别为6.4%和22.2%,差异显著(χ2=6.095,P=0.014),在二期的颅骨缺损修补中,治疗组和对照组的手术时间分别为(121.9±18.6)min vs.(156.1±14.6)min,出血量分别为(108.1±42.3)ml vs.(181.9±46.5)ml,硬脑膜破损率为3.8%vs.25%;差异均有统计学意义(P0.05)。结论在标准去骨瓣减压时使用神经补片修补硬脑膜能降低患者术后的癫痫发生率,同时有利于患者二期进行的颅骨缺损修补手术,能减少修补手术中的出血量及手术时间,减少副损伤。

The Effect of Neuro-Patch in Decompressive Operation with Removal of Bone Flap

Objective To investigate the effect of neuro-patch in decompressive operation with removal of bone flap. Methods In standard decompressive operation with removal of bone flap, there were seventyeight cases in therapeutic group used neuro-patch to repair cerebral dura mater, while 36 cases in control group used self-fasciai patch to repair the cerebral dura mater. The operation time, intraoperative bleeding volume, the number of breakage of cerebral dura mater and the epilepsy incidence rate in these two groups were compared. Results The epilepsy incidence rate was 6.4% and 22.2% respectively in the therapeutic group and the control group respectively. The bleeding volume was （ 108.1 ± 42.3 ） ml vs. （ 181.9 ± 46.5 ） ml, the operation time was（ 121.9 ± 18.6） min vs. （ 156.1 ± 14.6） min, the rate of breakage of cerebral dura mater was 3.8% vs. 25% respectively in therapeutic group and control groups, which all had significant difference（P 〈 0.05）. Conclusions It can decrease the epilepsy incidence rate, be benefit for the second stage repair operation, decrease the operation time, decrease the bleeding volume, and decrease the secondary damage in the standard decompressive operation with removal of bone flap using neuro-patch to repair the cerebral dura mater.