生物人工硬脑膜在颅脑损伤患者硬脑膜缺损中的应用

摘要

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.目的:观察并分析生物人工硬脑膜在颅脑损伤手术松弛缝合中修补硬膜缺损的临床资料,并评价其使用价值.方法:回顾性分析132例颅脑损伤中硬脑膜缺损者应用人工硬脑膜修补后的疗效及并发症随访结果.结果与结论:患者随访1年,共64例患者进入结果分析.应用人工硬脑膜后脑积水22例,皮下积液8例,硬膜外血肿4例,脑脊液切口漏2例、鼻漏1例,修复后头颅CT检查未见与人工脑膜有关的异常反应和表现.42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.说明实验所用生物型人工硬膜并发症少,相容性好,能够较好的与正常硬脑膜融合,保护脑皮质.%BACKGROUND: The integrity of the dura mater is very important for the prognosis of patients with head injury.OBJECTIVE: To observe and analyze the clinical data regarding the application of bio-artificial duramater in dural relaxing suturein patients with traumatic brain injury as well as to evaluate the use value.METHODS: We retrospectively reviewed the curative effects of bio-artificial duramater in the repair of dural defects in 132 casesof traumatic brain injury as well as follow-up results.RESULTS AND CONCLUSION: By the end of 1-year follow-up, 64 patients were included in result analysis. After operation,there were 22 cases of hydrocephalus, eight cases of subcutaneous effusion, four cases of extradural hematoma, two cases ofcerebrospinal fluid incision leakage and one case of rhinorrhea. After repair, head CT revealed no abnormal reactions related tobio-artificial duramater. Forty-two patients had a good fusion of artificial duramater and normal dura mater, and no adhesion andinflammatory reactions after 3-6 months. These findings indicate that bio-artificial duramater can reduce complications, have agood fusion with the normal dura mater and protect the cerebral cortex.