颅骨缺损状态下颅内压与颅骨缺损综合征关系的探讨

目的　探讨颅骨缺损的病理状态下颅内压力与颅骨缺损综合征关系。方法　对 147例颅骨缺损患者腰穿测定其颅骨修补手术前后颅内压力 ,并分析颅内压与颅骨缺损综合征的关系。结果　颅骨缺损面积≤ 2 5cm2 ,颅内压 95～ 16 5mmH2 O者 9例中 ,无 1例出现颅骨缺损综合征 ;颅骨缺损面积 2 5～ 35cm2 ,颅内压 40～ 15 0mmH2 O者 7例 ,占 2 6 9%(7/2 6 )出现颅骨缺损综合征 ;颅骨缺损面积≥ 35cm2 ,颅内压力 0～ 70mmH2 O者 112例 ,占 99 4% (112 /113)出现颅脑缺损综合征。 12 5例颅内压≤ 80mmH2 O ,其中 117例 (93 6 % )出现颅骨缺损综合征。颅骨修补后颅内压恢复正常后颅骨缺损综合征全部消失。结论　颅骨缺损的病理状态下 ,颅内压高低与颅骨缺损面积有关 ,颅内压降低可能是导致颅骨缺损综合征的重要原因。

Study of the Relations between Intracranial Pressure and Skull Defect Syndrome under the State of Skull Defect

Objective　To study the relations between intracranial pressure and skull defect syndrome under the pathologic state of skull defect. Method　The intracranial pressures of 147 patients with skull defect were measured through lumbar puncture before and after cranioplasty and the relations between intracranial pressure and skull defect syndrome were analyzed. Result　9 patient with skull defect area ≤25 cm2, intracranial pressure 95～165 mm H2O had no skull defect syndrome, 7 of 26 patients with skull defect area 25～35 cm2 intracranial pressure 40～150 mm H2O had skull defect syndrome, 112 of 113 patients with skull defect area ≥35 cm2, intracranial pressure 0～70 mm H2O had skull defect syndrome and 117 of 125 patients with intracranial pressure ≤80 mm H2O had skull defect syndrome. The skull defect syndrome disappeared after cranioplasty and after intracranial pressure recovered to normal. Conclusion　Under skull defect state the intracranial pressure has relations with skull defect area. The decrease of intracranial pressure may be an important cause leading to skull defect syndrome.