CAJ | 학술논문

目的探讨创伤性颅内静脉窦损伤患者的临床特点及急诊手术方法.方法回顾性分析2008年1月至2010年12月我院收治的22例颅内静脉窦损伤患者,分析其临床特点并采用明胶海绵直接压迫、直接或筋膜缝合修补、医用耳脑胶粘合、硬膜悬吊加固、静脉窦结扎等方法止血.结果术中发现上矢状窦损伤12例,横窦损伤6例,窦汇损伤2例,岩上窦损伤1例,乙状窦损伤1例.术中紧急修补静脉窦损伤19例,止血明确;行静脉窦结扎3例,其中2例为前1/3矢状窦,1例为右侧横窦.根据格拉斯哥预后评分,预后良好(GOS 4～5分)17例,预后差(GOS 2 ～3分)4例,死亡(GOS 1分)1例.结论对于靠近静脉窦处的颅脑损伤,术前做好应对静脉窦损伤的准备,术中尽早控制致命性大出血,根据静脉窦具体的损伤特点采用相应的修补方法,可提高创伤性颅内静脉窦损伤患者的抢救成功率.
목적 탐토창상성로내정맥두손상환자적림상특점급급진수술방법.방법 회고성분석2008년1월지2010년12월아원수치적22례로내정맥두손상환자,분석기림상특점병채용명효해면직접압박、직접혹근막봉합수보、의용이뇌효점합、경막현조가고、정맥두결찰등방법지혈.결과 술중발현상시상두손상12례,횡두손상6례,두회손상2례,암상두손상1례,을상두손상1례.술중긴급수보정맥두손상19례,지혈명학;행정맥두결찰3례,기중2례위전1/3시상두,1례위우측횡두.근거격랍사가예후평분,예후량호(GOS 4～5분)17례,예후차(GOS 2 ～3분)4례,사망(GOS 1분)1례.결론 대우고근정맥두처적로뇌손상,술전주호응대정맥두손상적준비,술중진조공제치명성대출혈,근거정맥두구체적손상특점채용상응적수보방법,가제고창상성로내정맥두손상환자적창구성공솔.
Objective To analyze the clinical features and evaluate surgical procedures of traumatic intracranial venous sinus injury.Methods From January 2008 to December 2010,we analyzed the clinical characteristics of 22venous sinus injury patients.They were compressed with gelatine spongedirectly,and sutured,and ligated sinus,with the aid of EC glue and suspended the dura to terminate the bleeding.Results We found 12 cases of superior sagittal sinus injury,6 cases of transverse sinus injury,2 cases of sinus exchange injury,1 case of rock sinus injury,1 case of sigmoid sinus injury.19 cases needed repair sinus,and 3 cases needed sinus ligation.According to Glasgow Outcome Scale,17cases had good prognosis(GOS 4-5),4 cases poor(GOS 2-3),1 death(GOS 1).Conclusion We should use the appropriate surgical approach dealing with different types of intracranial venous sinus injury,which can achieve satisfactory therapeutic effect.