生物型人工脑膜在颅脑手术中的应用

目的探讨生物型人工脑膜在颅脑手术中的应用价值。方法对66例颅脑手术中硬脑膜缺损患者应用生物型人工脑膜治疗,并对其术后疗效与并发症的情况进行分析。结果 66例患者中2例死亡（并发严重肺部感染、多器官功能衰竭）;2例出现创伤性脑梗死,植物生存;2例并发脑膨出,经弹力绷带适当约束后好转;癫间发作1例。余59例患者按照GOS分级,56例良好,3例中残。所有病例7～9 d如期拆线,无切口渗液、感染、皮肤过敏、组织排异反应等不良反应,未发生骨窗疝。其中36例患者在行Ⅱ期颅骨修补术中观察到生物型人工脑膜封闭,有良好的保护脑组织作用及良好的组织相容性,无炎症反应,解剖层次清晰。结论在颅脑手术中应用生物型人工脑膜安全、有效,可明显降低各种并发症,避免许多中枢神经系统的迟发性损害。

Application of Biological Artificial Dura Mater in Craniocerebral Surgery

Objective To study the application of biological artificial dura mater in craniocerebral surgery.Methods The biological artificial dura mater was used in craniocerebral surgery in 66 patients with dural defects.Curative effects and postoperative complications were observed and follow-up results were analyzed.Results Among the 66 patients,2 died（complicated by severe pulmonary infection and multiple organ failure）,2 had traumatic cerebral infarction and survived in a vegetative state,2 had encephalocele which was improved after proper constraints with elastic bandage,and 1 had seizures.Among the other 59 patients who were evaluated with the GOS,56 had good recovery and 3 had moderate disability.Stitches were removed after 7-9 days.No patients had wound exudation,infection,skin allergies,rejection reaction and other adverse reactions.No herniation in bone windows occurred in all patients.During stage Ⅱ cranioplasty,biological artificial dura mater resulted in the closure of dura mater and protection of brain tissue with good tissue compatibility and clear anatomical levels in 36 patients,and no inflammatory response was found.Conclusion The biological artificial dura mater is safe and effective in the craniocerebral surgery,and can reduce complications and avoid the delayed damage of central nervous system.