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背景:硬膜的完整性对于颅脑损伤患者手术的预后十分重要。人工硬脑膜是目前常见的硬脑膜修补材料,寻找理想的人工硬脑膜是神经外科探索的方向。目的:观察并分析胶原海绵人工硬脑膜和臭氧治疗颅脑损伤患者的临床资料,探讨并评价其使用价值。方法:回顾性分析60例颅脑损伤患者应用胶原海绵人工硬脑膜修补和臭氧治疗后的疗效及并发症随访结果。结果与结论:患者中2例死于重型颅脑损伤术后弥漫性脑肿胀,1例死于脑损伤合并多器官衰竭,2例因广泛脑挫裂伤合并脑疝术后植物生存,其余55例患者进入结果分析。术后2例出现切口局部皮下积液,予穿刺抽吸及弹性绷带加压包扎后好转;1例术后出现术侧少量硬膜下积液,未行特殊处理,动态复查头颅CT显示积液逐步吸收减少。头颅CT检查未见与人工脑膜有关的异常反应和表现。28例患者3-6个月进行颅骨修补时发现人工硬脑膜与正常硬脑膜融合恢复较好,无粘连及炎症反应发生。表明胶原海绵人工硬脑膜和臭氧在颅脑损伤患者治疗中充分发挥减压作用,维持脑功能,缩短手术时间,并发症少,相容性好,能够较好的与正常硬脑膜融合,保护脑皮质,为后期颅骨修补创造有利条件。
Background: The integrity of the dura mater is important for the prognosis of patients with brain injury. Artificial dura mater is the common dural repair material, looking for the ideal artificial dura is the direction of neurosurgical exploration. OBJECTIVE: To observe and analyze the clinical data of collagen sponge artificial dura mater and ozone therapy for patients with craniocerebral injury, and to explore and evaluate its value. Methods: The curative effect and complication follow-up of 60 cases of traumatic brain injury treated by artificial dura mater repair and ozone therapy with collagen sponge were retrospectively analyzed. RESULTS AND CONCLUSION: Two patients died of diffuse brain swelling after severe craniocerebral injury, one died of brain injury combined with multiple organ failure, and the other two survived after extensive cerebral contusion and brain hernia. The remaining 55 Patients entered the result analysis. There were 2 cases of incision subcutaneous effusion after surgery, puncture and suction and elastic bandage after compression dressing improved; 1 case of postoperative small amount of subdural effusion, without special treatment, dynamic review head CT showed fluid Gradually absorbed less. Head CT examination showed no abnormal reaction and performance associated with artificial meninges. 28 cases of 3-6 months cranial repair found artificial dura and dura fusion recovery, no adhesion and inflammation. Collagen sponge artificial dura and ozone in the treatment of patients with craniocerebral injury showed that the full decompression effect, maintain brain function, shorten the operation time, less complications, good compatibility, better able to fuse with the normal dura, protect the brain Cortex, skull repair for the creation of favorable conditions.