摘要
目的分析优化手术流程在深低温保存钴-60灭菌自体颅骨修补颅骨缺损手术降低近期(1个月)并发症发生率的方法、优点及意义。方法回顾性分析我院2018年10月~2020年10月收治的46例颅骨缺损病人的临床资料,全部采用深低温保存自体颅骨修补颅骨缺损。根据术前颅骨处理方式不同分为两组,实验组24例,采用80℃无菌生理盐水1000 ml+地塞米松20 mg复温30分钟;对照组22例,采用传统处理方式。结果实验组皮下积液1例;对照组硬膜外血肿2例,皮下积液11例,其中严重皮下积液1例,颅骨感染1例(再手术)。通过80℃无菌生理盐水+地塞米松20 mg复温30分钟,大大减少手术近期并发症,提升手术效果及病人舒适度。随访证实无骨瓣塌陷、无骨髓炎、无皮下积液。结论改进颅骨处理方式能大大降低深低温保存自体颅骨修补颅骨缺损近期并发症。对于有条件开展自体颅骨修补的单位值得推荐,是一种简便、经济、安全、可行的方法。
Objective To explore the method,advantages and significance of optimizing the operation process in cryopreservation of cobalt-60 sterilized autologous skull for repairing skull defects in order to reduce the short-term(January)complications.Methods From October 2018 to October 2020,46 patients with skull defect were treated in our hospital,all of them were treated with deep hypothermia preservation of autologous skull to repair skull defect.According to the different preoperative cranial treatment methods,they were divided into two groups,the experimental group 24 cases,80℃sterile saline 1000 ml+dexamethasone 20 mg was used,reheated for 30 minutes.The control group(22 cases)received traditional treatment.Results In experimental group,there was 1 case of subcutaneous effusion.In control group,there were 2 cases of epidural hematoma,11 cases of subcutaneous effusion,including 1 case of severe subcutaneous effusion and 1 case of skull infection(reoperation).By improving and optimizing the original operation process,the short-term complications were greatly reduced,and the operation effect and patient comfort were improved.No bone flap collapse,osteomyelitis and subcutaneous effusion were found during follow-up.Conclusion Improving and optimizing the operation process can greatly reduce the short-term complications of deep hypothermic preservation of autologous skull repair of skull defects,which has a wide application prospect.It is a simple,economic,safe and feasible method for the units that have the conditions to carry out autologous skull repair.
作者
江竟成
张超
王瀚
邓青山
吴蛟
罗鹏
邱俊
周世军
陶裕川
徐小平
屈小琴
向玉
易勇
JIANG Jingcheng;ZHANG Chao;WANG Han(Department of Neurological Surgery,Yibin Second People's Hospital of West China Hospital of Sichuan University Yibin Hospital,Sichuan,Yibin 644000,China)
出处
《临床外科杂志》
2021年第9期821-823,共3页
Journal of Clinical Surgery
关键词
自体颅骨
颅骨缺损
颅骨修补
并发症
autologous skull
skull defect
skull repair
complications
