粉碎性前颅底骨折重建与修补分析.docVIP

粉碎性前颅底骨折重建与修补分析 　　【摘要】 目的：分析粉碎性前颅底骨折的重建与修补方法与效果。方法：选取2012年5月-2014年8月在本院进行治疗的粉碎性前颅底骨折患者60例为研究对象进行回顾性分析，根据CT检查结果实施骨性重建与膜性重建修补手术，使用钛网及患者自身骨体为修补材料，观察记录术后恢复情况及CT复查结果。结果：60例患者中1例因伤势过重死亡，2例患者因颈内动脉损伤先实施了介入治疗，后行重建修补手术，59例患者手术均成功。随访期间，2例颅内感染，1例脑脊液漏，1例眶颅穿通术后感染，经二次手术、腰穿引流等治疗后均好转，CT复查显示骨折与缺损处修补效果佳，骨质连续性好，未见脑膜膨出及脑脊液漏等并发症。结论：粉碎性前颅底骨折患者实施骨性重建与膜性重建修补可有效恢复缺损骨质硬脑膜，并发症发生率低，手术效果好，值得大力应用推广。 　　【关键词】 粉碎性前颅底骨折； 骨性重建； 膜性重建； 脑脊液漏； 并发症 　　【Abstract】 Objective： To analyze the reconstruction and repairing methods and effects of comminuted fractures of anterior skull base. Method： 60 patients who suffered from the comminuted fractures of anterior skull base and who accepted treatment in our hospital from May 2012 to August 2014 were taken as the research objects to take the retrospective analysis. According to the CT examine results， the osseous reconstruction and the membranous reconstruction repairing surgeries were conducted. In addition， taking the titanium mesh and patients’ own bones as the repairing materials， the recovery situation after surgeries and the CT re-examine results were observed and written down. Result： Among 60 patients， one of them died due to the serious injuries， two of them were conducted the interventional therapy because of the internal artery injuries and were conducted the reconstruction and repairing surgeries later on. Then， the surgeris of another 59 of them succeeded. During the follow-up period， two of them suffered from intracranial infection， one of them suffered from leakage of cerebrospinal， one of them suffered from infection after the cranial through surgery. After the second surgery and the treatment of lumbar continuous drainage of fluid， the repairing effects at the places of fracture were good， and the continuity of bones was good without the complications of cranial meningocede and the leakage of cerebrospinal. Conclusion： The application of the osseous reconstruction and the membranous reconstruction repairing on the patients who suffer from commi