后颅脑肿瘤开颅术中硬脑膜重建研究.docVIP

后颅脑肿瘤开颅术中硬脑膜重建研究 　　【摘要】 目的 探究后颅脑肿瘤开颅术中硬脑膜重建的材料、方法与效果。方法 200例神经外科患者， 随机分为观察组和对照组， 各100例。观察组使用枕下正中或枕下正中向外切口入路， Y形或H形切开硬脑膜后， 用双极弱电流电凝硬脑膜边缘出血， 待术后进行硬脑膜重建；对照组采取后颅窝开颅术（无硬脑膜重建）。对比两组的术后恢复情况和患者满意度。结果 观察组患者术后恢复情况优于对照组（P0.05）；观察组患者满意度高于对照组（P0.05）。结论 后颅窝硬脑膜缝合是手术环节的重要一环， 能有效减少脑脊液漏。通过无损伤不可吸收缝线连续缝合粘连更轻， 局部筋膜修补比较经济实惠， 因此连续缝合更符合现状。 　　【关键词】 后颅脑肿瘤开颅术；硬脑膜重建；相关研究 　　DOI：10.14163/j.cnki.11-5547/r.2015.27.006 　　Research of dural reconstruction in posterior intracranial tumor craniotomy CAI Wei-ping. Department of Neurosurgery， Affiliated Zhangzhou Hospital of Fujian Medical University， Zhangzhou 363000， China 　　【Abstract】 Objective To investigate material， method and effect for dural reconstruction in posterior intracranial tumor craniotomy. Methods A total of 200 patients in department of neurosurgery were randomly divided into observation group and control group， with 100 cases in each group. The observation group received middle suboccipital or outside incision approach， bipolar low current for endocranium edge blood coagulation after Y or H cut of endocranium， and postoperative dural reconstruction. The control group received posterior cranial fossa craniotomy （without dural reconstruction）. Comparisons were made on postoperative recovery and patients’ satisfaction degree. Results The observation group had better postoperative recovery condition than the control group （P0.05）. Patients’ satisfaction degree in the observation group was higher than the control group （P0.05）. Conclusion Posterior cranial fossa dural suture is an important section in surgery， and it can effectively reduce leakage of cerebrospinal fluid. Implement of non-invasive non-absorbable suture can provide slight continuous suture and economical partial fascia repair. Therefore， continuous suture is practical. 　　【Key words】 Posterior intracranial tumor craniotomy； Dural reconstruction； Correlation research 　　后颅窝开颅术又被称为颅后窝开颅术， 属于神经外科的一门手术， 主要应用于颅脑部疾病。开颅术分为两个类型， 骨窗开颅和骨瓣开颅。行开颅手术要求手术医生必须对病变的位置非常熟悉， 并且能够准确定位并进入[1]