《中国康复理论与实践》

《中国康复理论与实践》

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颅骨修补术后常见并发症分析①

王建军，孙炜，周剑云，张新，王利清，王宇，高海滨，李达，曹泽，胡安明   

  1. 1.首都医科大学康复医学院，北京市100068；2.北京脑重大疾病研究院，北京市100068；3.中国康复研究中心北京博爱医院神经外科，北京市100068。
  • 出版日期:2016-06-25 发布日期:2016-07-04

Analysis of Common Postoperative Complications after Cranioplasty

WANG Jian-jun, SUN Wei, ZHOU Jian-yun, ZHANG Xin, WANG Li-qing, WANG Yu, GAO Hai-bing, LI Da, CAO Ze, HU An-ming   

  1. 1. Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China; 2. Beijing Institute for Brain Disorders, Beijing 100068, China; 3. Department of Neurosurgery, Beijing Bo'ai Hospital, China Rehabilitation Research Centre, Beijing 100068, China
  • Published:2016-06-25 Online:2016-07-04

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摘要： 目的探讨颅骨修补术后头皮下积液、癫痫和自发性脑出血发生的相关因素。方法回顾分析2009 年11 月~2013 年6月本院颅骨修补术后患者211 例，均采用二维钛合金网板修补材料。术后常规护理治疗，对出现相关并发症按诊疗常规积极处理。统计术后术侧头皮下积液、癫痫和自发性脑出血的发生情况，对可能的相关因素，包括性别、年龄、原发病因、颅骨缺损部位、发病至修补术时间、术前并发脑积水情况以及术中硬膜破损情况进行分析。结果患者三种并发症总发生率为4.7%(10/211)。术后出现术侧头皮下积液4 例，癫痫发作5 例，自发性脑出血1 例。头皮下积液与术前存在脑积水(χ2=4.804, P=0.028)及术中硬膜破损(χ2=7.510, P=0.006)相关。癫痫发作及自发性脑出血与以上因素不相关(P>0.05)。结论术中严密修补破损硬膜，术后及时处理脑积水，可以减少术后头皮下积液的发生。

关键词: 颅骨缺损修补术, 去骨瓣减压术, 并发症

Abstract: Objective To explore the related factors of common postoperative complications after cranioplasty. Methods From November, 2009 to June, 2013, a total of 211 patients after cranioplasty were reviewed. The conventional two-dimensional titanium alloy was used. The incidence of scalp effusion, seizure and spontaneous intracerebral hemorrhage were recorded, and the related factors including gender, age, primary disease, skull defect site, attack time, concomitant hydrocephalus and intraoperative dural damage were analyzed. Results The incidence of these complications was 4.7% (10/211) in total. There were four cases with scalp effusion, five cases with seizures and one case with spontaneous intracerebral hemorrhage. The scalp effusion was related to hydrocephalus (χ2=4.804, P=0.028) and intraoperative dural damage (χ2=7.510, P=0.006). Seizure and spontaneous intracerebral hemorrhage were not related with any factors above (P>0.05). Conclusion The occurrence of postoperative scalp effusion can be reduced by repairing intraoperative dural damage, and dealing with extreme hydrocephalus timely.

Key words: cranioplasty, decompressive craniectomy, complication