CAJ | 학술논문

背景：数字成型钛网修补颅骨缺损后常发生皮下积液等不良反应，影响治疗效果。目的：探讨数字成型钛网修补颅骨后发生皮下积液的原因及相应的防治措施。 　　方法：回顾性分析19例行数字成型钛网修补颅骨后皮下积液患者的临床资料和处理方式，总结修补后并发症发生原因，探讨有效的防治方法。 　　结果与结论：19例修补中硬膜破损5例，材料刺激4例，下床过早3例，拔管过早3例，术后修补时间过长3例，过度使用电刀1例，考虑皮下积液的发生与上述因素相关，硬膜破损与材料刺激为术后皮下积液的主要原因，出现皮下积液后均给予松解弹力绷带，待积液达到皮下后行穿刺抽吸，严格卧床等积极处理后全部治愈。引起皮下积液的原因可能会单发或混合出现，但上述仅仅是部分原因，有文献显示未中心悬吊、止血不彻底、术前骨窗过于塌陷等均是发生皮下积液的原因。
배경：수자성형태망수보로골결손후상발생피하적액등불량반응，영향치료효과。목적：탐토수자성형태망수보로골후발생피하적액적원인급상응적방치조시。 　　방법：회고성분석19례행수자성형태망수보로골후피하적액환자적림상자료화처리방식，총결수보후병발증발생원인，탐토유효적방치방법。 　　결과여결론：19례수보중경막파손5례，재료자격4례，하상과조3례，발관과조3례，술후수보시간과장3례，과도사용전도1례，고필피하적액적발생여상술인소상관，경막파손여재료자격위술후피하적액적주요원인，출현피하적액후균급여송해탄력붕대，대적액체도피하후행천자추흡，엄격와상등적겁처리후전부치유。인기피하적액적원인가능회단발혹혼합출현，단상술부부시부분원인，유문헌현시미중심현조、지혈불철저、술전골창과우탑함등균시발생피하적액적원인。
BACKGROUND:Subcutaneous effusion often occurs after digital shaping titanium mesh cranioplasty, and affects therapeutic effects. OBJECTIVE:To explore the causes and corresponding prevention measures of subcutaneous effusion after digital shaping titanium mesh cranioplasty. METHODS: We retrospectively analyzed the clinical data and treatment methods of 19 cases of subcutaneous effusion after digital shaping titanium mesh cranioplasty, summarized the postoperative complications and explored the effective methods for prevention and treatment of subcutaneous effusion. RESULTS AND CONCLUSION: After active treatment, five cases of dural breakage, four cases of foreign body stimulation, three cases of getting out of bed early, three cases of early extubation, three cases of long-time operation repair, and one case of excessive use of electric knife were al cured. Dural breakage and foreign body stimulation is considered as the main causes of postoperative effusion. Patients with subcutaneous effusion were given releasing elastic bandage, aspiration, and strict bed rest. After these active treatments, patients were al cured. Subcutaneous effusion may result from single or mixed factors. The above-mentioned causes are only a part. Non-central suspension, incomplete hemostasis, and preoperative excessive colapse of the bone window are al reported to be the reasons for the occurrence of subcutaneous effusion.