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目的总结上矢状窦损伤的治疗经验,提高此类患者的疗效。方法回顾我科近5年61例上矢状窦损伤的临床资料。分析上矢状窦损伤的手术时机、手术方法以及术中控制性低血压的应用,对于不同类型血肿在合适的时机采取合适的手术方法及术后根据不同患者进行个体化的处理,着重探讨不同上矢状窦损伤的手术原则、手术策略、术中、术后处理等方面的问题。结果61例患者均行手术治疗,术后随访3月,恢复良好29例(47.5%),中残19例(31.1%),重残11例(18.0%),植物生存3例(4.9%),死亡8例(13.1%)。结论术前充分准备,选择正确手术入路和修补方法是成功救治上矢状窦损伤的关键,根据患者具体选择合适的手术时机和方法治疗提高治愈率,改善预后。
Objective To summarize the experience of treatment of sagittal sinus injury and to improve the curative effect of such patients. Methods The clinical data of 61 cases of superior sagittal sinus injury in our department in the recent 5 years were retrospectively reviewed. To analyze the operation timing and surgical methods of upper sagittal sinus and the application of intraoperative controlled hypotension, and to explore the different treatment methods for different types of hematomas at appropriate timing and individualized treatment according to different patients after surgery The surgical principle of sagittal sinus injury, surgical strategies, intraoperative, postoperative management and other aspects. Results Sixty-one patients were treated surgically. There were 29 cases (47.5%) recovered well, 19 (31.1%) moderately disabled, 11 (18.0%) severely disabled and 3 (4.9% , 8 died (13.1%). Conclusion The adequate preoperative preparation, proper surgical approach and repair method are the keys to successful treatment of superior sagittal sinus injury. According to the specific choice of patients, the appropriate timing and method of operation should be used to improve the cure rate and improve the prognosis.