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目的分析小儿后颅窝开颅术后枕部皮下积液形成的原因,并探讨其防治措施。方法回顾性分析我院2010—2013年收治的12例儿童,年龄1~8岁,平均4.5岁,后颅窝开颅术后枕部皮下积液患者的临床资料。结果 11例患儿治愈,1例患儿皮下积液合并脑积水迁延不愈,家属要求自动出院。其中6例经腰大池置管持续引流加枕颈部加压包扎治愈,5例经积液腔置管持续引流枕颈部加压包扎+腰椎穿刺持续引流治愈,无一例再次打开切口手术处理。结论小儿枕颈部肌肉不发达,且术中硬膜、枕下肌肉层和皮下组织缝合不严密及局部遗留死腔是枕部皮下积液形成的主要原因,除传统腰大池置管持续引流外,积液腔置管持续引流枕颈部加压包扎效果肯定。
Objective To analyze the causes of occipital subcutaneous effusion after pediatric craniotomy craniotomy and to explore its prevention and treatment. Methods The clinical data of 12 children aged from 1 to 8 years old with an average of 4.5 years old who received suboccipital hydronephrosis after craniotomy craniotomy during 2010-2013 were retrospectively analyzed. Results 11 cases of children were cured, 1 case of children with subcutaneous fluid and hydrocephalus delayed healing, family members asked to be discharged automatically. Among them, 6 cases were continuously drained through the lumbar cistern and the neck of the occiput was pressurized and bandaged. Five cases were treated by continuous drainage of the hydrothorax and the neck by compression bandage and lumbar puncture for continuous drainage. None of the cases were reopened for incision surgery. Conclusion Pediatric occipital neck muscle is underdeveloped, and intraoperative hard membrane, suboccipital muscle layer and subcutaneous tissue suture is not tight and local dead space is the main reason for occipital subcutaneous fluid formation, in addition to the traditional lumbar drainage tube continuous drainage , Effusion tube continued drainage pillow neck compression bandage affirmation.