标题：一期修复颅骨粉碎性骨折41例

      作者：庄之剑 1，王青松 2，林婷婷 2，李 钢 2
    (1.文昌市人民医院外三科，海南 文昌 571300；
2.中国人民解放军总医院海南分院神经外科，海南 三亚 572013)

      卷次： 2013年24卷3期

      【摘要】 目的 探讨应用自体碎骨片行颅骨粉碎性骨折一期修复的方法及效果。方法 对41例颅骨粉碎
性骨折常规清创处理，将碎骨片用聚维酮碘处理后，再以1‰庆大霉素生理盐水浸泡，复位于骨缺损区，从骨片间
隙中将硬脑膜与帽状腱膜对应缝合固定骨片，头皮分层缝合。结果 所有病例无感染及皮下积液，术后复查X
线颅骨片或头颅CT扫描显示颅骨碎片愈合，外观塑形好。结论 颅骨粉碎性骨折摘除碎骨片将造成颅骨缺损，
将碎骨片复位修复愈合良好，减少了患者再次手术的痛苦，有利于患者康复，对脑组织起到很好的保护作用。

      【关键词】 颅脑创伤；颅骨骨折；颅骨成形术

      【中图分类号】 R683.5 【文献标识码】 A 【文章编号】 1003—6350（2013）03—0398—03


One stage repair of comminuted skull fracture: a report of 41 cases.
ZHUANG Zhi-jian 1, WANG Qing-song 2, LIN
Ting-ting 2, LI Gang 2. 1. The Third Department of Surgery, the People's Hospital of Wenchang City, Wenchang 571300,
Hainan, CHINA; 2. Department of Neurosurgery, Hainan Branch of People's Liberation Army General Hospital, Sanya,
572013, Hainan, CHINA

【Abstract】 Objective To observe and study the clinical effect of surgical repair using broken skull pieces in
the treatment of comminuted skull fracture. Methods Forty-one patients with comminuted skull fracture underwent
debridement in acute stage. The broken skull pieces was taken out, disinfected with povidone iodine, and soaked in
1‰ gentamicin/normal saline for more than 30 minutes. Then the broken pieces were replaced into the defect area ac-
cording to the original shape, and duramater was sewed to galea between the bone pieces in order to fix these pieces.
The scalp was sewed according separated layers to close wounds. Results No infection and subcutaneous accumula-
tion of liquid were found in any of the patients after operation. The X ray reexamine or CT scanning showed coales-
cence between the broken skull pieces and satisfactory remodeling of the skull appearance. Conclusion The extrac-
·临床经验·doi:10.3969/j.issn.1003-6350.2013.03.0174