微血管减压术后皮下积液的预防及处理.pdfVIP

2008年第21卷第3期 Chin J Stereotact Funct Neurosurg，Jun 08，v()1． ! ! 159 论著 微血管减压术后皮下积液的预防及处理 王旭辉 李世亭 张文川 仲 骏 万 亮 李心远 杨 敏 孟佑强 [摘要] 目的 探讨微血管减压术后皮下积液的预防及处理。方法 回顾性分析752例患者微血管减压术 后7例发生皮下积液的原因、治疗方法及疗效。结果 7例皮下积液患者均痊愈，其中2例经穿刺抽吸加压包扎治 愈，5例再次打开切口行手术修补。结论 术中硬膜、枕下肌肉层和皮下组织缝合不严密及局部遗留死腔是皮下积 液形成的主要原因。皮下积液发生后可通过积液腔穿刺抽吸、加压包扎处理，经保守治疗无效者可行手术修补。 [关键词] 微血管减压术；并发症；皮下积液；脑神经 中图分类号：R745．1 文献标识码：A 文章编号：1008--2425(2008)O3一O159一O3 Prevention and therapy of Scalp Hydrops after microvascular decompression of cranial nerves Wang Xuhui，Li Shiting，Zhang Wenchuan，et a1．Department of Neurosurgoy，Xinhua Hos— pital，School of ivied icine，Shanghai Jiaotong University，Shanghai，200092，China [Abstract] Objective explore the prevention and therapy of scalp hydrops after microvas- cular decompression of cranial nerves．Methods We reviewed retrospectively the clinical data of 7 patients who had scalp hydrops after microvascular decompression of cranial nerves in 752 pa— tients．Results The 7 patients were cured completely，of whom 2 cases were cured by puncture， pressure and binding，5 cases need to be repaired by operation again．Conclusion Dural，suboc— cipital muscle layers and subcutaneous tissues are not sewed closely and left lacunas during opera— tion are the main causes of scalp hydrops。Pressure and binding after puncture scalp hydrops was confirmed effectively，and repairing by another operation can be replied after conservative therapy does not work． [-Key wordsJ Microvascular decompression~Complications~Scalp hydrops Cranial nerves 微血管减压术(microvascular decompression， 752例，随着临床实践 的不断积累和手术技术的发 MVD)是通过显微手术解除颅内微血管对脑神经的 展，不仅提高了手术疗效，也在防治术后皮下积液这 压迫而解除患者病痛的方法。目前，MVD在功能 方面积累了一定的经验，现报道如下。 神经外科领域主要用于治疗三叉神经痛、面肌痉挛 资料与方法 以及舌咽神经痛等脑神经