CAJ | 학술논문

目的探讨显微镜联合神经内镜行颅底重建治疗创伤性脑组织鼻漏的手术疗效及应用价值.方法回顾性分析武警广东总队医院神经外科自2009年6月至2012年6月收治的16例创伤性脑组织鼻漏患者的临床资料,患者均在显微镜下采用带蒂骨膜筋膜瓣和钛网、生物胶等行颅底重建,再用神经内镜经鼻腔检查、完善,术后随访5～36个月观察疗效.结果 16例患者中13例恢复良好,未再出现脑脊液漏和脑膜膨出；1例因原发脑损伤伤情过重死亡；2例出现脑脊液漏,其中1例因原发脑损伤伤情重和颅内感染死亡,1例经腰大池置管引流2周后治愈.结论在显微镜和神经内镜联合下行颅底重建对脑组织或脑脊液鼻漏的疗效提高具有重要意义.
목적 탐토현미경연합신경내경행로저중건치료창상성뇌조직비루적수술료효급응용개치.방법 회고성분석무경엄동총대의원신경외과자2009년6월지2012년6월수치적16례창상성뇌조직비루환자적림상자료,환자균재현미경하채용대체골막근막판화태망、생물효등행로저중건,재용신경내경경비강검사、완선,술후수방5～36개월관찰료효.결과 16례환자중13례회복량호,미재출현뇌척액루화뇌막팽출；1례인원발뇌손상상정과중사망；2례출현뇌척액루,기중1례인원발뇌손상상정중화로내감염사망,1례경요대지치관인류2주후치유.결론 재현미경화신경내경연합하행로저중건대뇌조직혹뇌척액비루적료효제고구유중요의의.
Objective To explore the surgical technique of traumatic cranionasal encephalocele by microscopy and endoscopy.Methods The clinical data of 16 patients with traumatic cranionasal encephalocele,admitted to our hospital from June 2009 to June 2012,were analyzed retrospectively.Anterior skull base defects in all patients were reconstructed by continuous vascularized pericranium and tanium mesh,and the operation was performed under microscopy and endoscopy.Follow-up was performed for 5-36 months.Results Of the 16 patients,13 recovered well without complication; one died of heavy head injury; two had cerebrospinal fluid leakage,including one cured after treating lumbar cistem drainages and one died resulting from intracranial infection.Conclusion Skull base reconstruction by the microscopy and endoscopy can improve the curative effects.