生物型人工硬脑膜修补硬脑膜缺损

背景：修复硬脑膜的完整性对于脑膜瘤患者的手术预后非常重要。目的：探讨生物型人工硬脑膜在大型凸面硬脑膜瘤修复中的应用价值。方法：回顾性分析56例因肿瘤侵蚀导致硬膜缺损的大型凸面脑膜瘤病例,术中采用人工硬脑膜修复硬膜缺损的临床疗效、并发症及随访结果。结果与结论：除2例并发局部积液,1例出现术侧少量硬膜下积液,1例出现迟发性硬膜外血肿外,其余病例均无脑脊液漏、颅内感染、癫痫、组织排异等不良反应发生。术后复查头颅CT及MR,证实植入人工硬膜的部位未见异常影像学改变。5例患者修复后3个月行颅骨修补,发现人工硬脑膜与正常硬脑膜融合良好,无粘连及炎症反应发生。说明生物型人工硬脑膜能够较好地重塑颅腔原有解剖层次,保护脑皮质,显著降低各种并发症的发生。

Bio-artificial dura mater in repair of dural defects

BACKGROUND： Repairing integrity of the dura mater is very important for the prognosis of patients with convex meningioma. OBJECTIVE： To investigate the application value of bio-artificial dura mater on giant convex meningioma. METHODS： The retrospective analysis of 56 cases of dural defects due to tumor erosion in patients with giant convex meningioma was carried out. Meanwhile, the clinical efficacy, complications and follow-up results of the repair with artificial dura mater were analyzed. RESULTS AND CONCLUSION： Except two cases complicated with local effusion, one case with a small volume of subdural effusion in operative side, one case with tardive epidural hematoma, the remaining patients had no cerebrospinal fluid leakage, intracranial infection, epilepsy, tissue rejection and other adverse reactions. Postoperative CT and MR examinations confirmed the site of implantation of artificial dura without abnormal radiographic changes. Five patients underwent cranioplasty of skull repair in 3 months postoperatively, and the intraoperative findings showed that the artificial dura mater had a good fusion with normal dura mater, with no adhesions and inflammatory reactions. These findings indicate that bio-artificial dura mater can reshape the original anatomical level, protect the cerebral cortex, and reduce the incidence of various cOmplications significantly.