胶原海绵人工硬脑膜结合臭氧修复颅脑损伤

背景：硬膜的完整性对于颅脑损伤患者手术的预后十分重要。人工硬脑膜是目前常见的硬脑膜修补材料，寻找理想的人工硬脑膜是神经外科探索的方向。目的：观察并分析胶原海绵人工硬脑膜和臭氧治疗颅脑损伤患者的临床资料，探讨并评价其使用价值。方法：回顾性分析60例颅脑损伤患者应用胶原海绵人工硬脑膜修补和臭氧治疗后的疗效及并发症随访结果。结果与结论：患者中2例死于重型颅脑损伤术后弥漫性脑肿胀，1例死于脑损伤合并多器官衰竭，2例因广泛脑挫裂伤合并脑疝术后植物生存，其余55例患者进入结果分析。术后2例出现切口局部皮下积液，予穿刺抽吸及弹性绷带加压包扎后好转；1例术后出现术侧少量硬膜下积液，未行特殊处理，动态复查头颅CT显示积液逐步吸收减少。头颅CT 检查未见与人工脑膜有关的异常反应和表现。28例患者3-6个月进行颅骨修补时发现人工硬脑膜与正常硬脑膜融合恢复较好，无粘连及炎症反应发生。表明胶原海绵人工硬脑膜和臭氧在颅脑损伤患者治疗中充分发挥减压作用，维持脑功能，缩短手术时间，并发症少，相容性好，能够较好的与正常硬脑膜融合，保护脑皮质，为后期颅骨修补创造有利条件。

Collagen sponge as an artificial dura mater combined with ozone to repair brain injury

BACKGROUND:The integrity of the dura mater is very important for prognosis of patients with brain injury prognosis. Artificial dura mater is a commonly repair material, and to look for an ideal artificial dura mater is the exploration direction in the neurosurgery field.OBJECTIVE:To observe and analyze the clinical data of brain injury patients undergoing repair of collagen sponge as dura mater substitute material with ozone therapy, and to explore and evaluate its clinical value.METHODS:Follow-up results of therapeutic efficacy and complications in 60 cases of brain injury following repair with collagen sponge artificial dura mater and ozone treatment were retrospectively analyzed.RESULTS AND CONCLUSION:Two patients died of postoperative diffuse brain swelling, one died of brain injury with multiple organ failures, and two cases of extensive brain injury accompanied by cerebral herniation were in vegetative state. The rest 55 patients were enrolled in the final analysis. After surgery, two patients appeared to have postoperative subcutaneous fluid and their conditions improved following puncture aspiration and pressure dressing with elastic bandage; another patient showed a small amount of subdural effusion, but did not undergo special treatment, and dynamic head CT showed the effusion was gradually reduced. Cranial CT examination showed no abnormalities associated with the artificial dura mater. At 3-6 months after surgery, the artificial dura mater was fused well with the normal dura mater in 28 cases undergoing skull patching, and there was no adhesion and inflammatory reaction. Taken together, the collagen sponge artificial dura mater with ozone can give full play to the decompression treatment of traumatic brain injury, which can maintain the brain function, shorter operative time, result in fewer complications, and have good compatibility, and moreover, the artificial dura mater can be fused well with the normal dura to protect the brain cortex, thereby providing favorable conditions for the latter skull repair.