Cartwright Cathy C, Jimenez David F, Barone Constance M, Baker Lynette
University of Missouri Healthcare, Columbia, MO, USA.
J Neurosci Nurs. 2003 Jun;35(3):130-8. doi: 10.1097/01376517-200306000-00002.
Traditionally, surgical correction of craniosynostosis involves calvarial remodeling, large blood losses necessitating transfusions, hospital stays of several days, and less-than-satisfactory results. In this study, outcomes from a minimally invasive technique called endoscopic strip craniectomy, along with a postoperative molding helmet, to correct craniosynostosis in young infants were evaluated. The endoscopic strip craniectomy was performed on 185 patients with clinical signs of craniosynostosis, with the following distribution: 107 sagittal, 42 coronal, 37 metopic, and 7 lambdoid, for a total of 198 sutures. The mean blood loss was 29.4 cc, and only two patients underwent intraoperative blood transfusion. Fourteen patients underwent postoperative blood transfusion; none was life-threatening. There were no deaths, complications, neurological injuries, or infections. All but six patients were discharged on the first postoperative day. A majority of the patients achieved or approached normocephaly, and there were no complications. Neuroscience nurses need to be aware of this technique when they discuss treatment options with the families of infants with craniosynostosis.
传统上,颅缝早闭的手术矫正包括颅骨重塑、因大量失血而需要输血、住院数天以及不尽人意的治疗效果。在本研究中,对一种名为内镜下条带颅骨切除术的微创技术以及术后塑形头盔矫正幼儿颅缝早闭的效果进行了评估。对185例有颅缝早闭临床体征的患者实施了内镜下条带颅骨切除术,分布情况如下:矢状缝107例、冠状缝42例、额缝37例、人字缝7例,共计198条缝线。平均失血量为29.4毫升,只有2例患者在术中输血。14例患者术后输血;均无生命危险。无死亡、并发症、神经损伤或感染。除6例患者外,所有患者均在术后第一天出院。大多数患者实现或接近头型正常,且无并发症。神经科学护士在与颅缝早闭婴儿的家属讨论治疗方案时需要了解这种技术。