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曹红宾 三甲
曹红宾 副主任医师
河北省儿童医院 小儿神经外科

小婴儿头皮血肿钙化的临床特征及外科治疗

中华小儿外科杂志2014第3期 小婴儿头皮血肿钙化的临床特征及外科治疗 曹红宾,王贤书,杨志国等 Clinical features and surgical management of infantile calcified cephalohematoma 目的 探讨小婴儿头皮血肿钙化的临床特征及外科治疗方法.方法 对河北省儿童医院神经外科2011年01月至2012年12月手术治疗的14例小婴儿头皮血肿钙化的临床特征、手术步骤、手术细节及预后等进行回顾性分析.全身麻醉下于钙化血肿表面行弧形切口,在帽状腱膜下或骨膜下剥离皮瓣,切开钙化血肿囊,吸净囊液,迅速咬除新生骨质及纤维板以减少出血,过程中注意保护骨膜及硬脑膜,将骨膜完整贴附于萎缩骨板.术后随访3至24个月.结果 本组14例患儿均为新生儿头皮血肿未吸收且未及时穿刺抽吸发展而来,平均就诊年龄2个月,位于单侧或双侧头顶部,手术采用新生骨质切除骨膜贴附法,手术的关键点是恢复骨膜与颅板的解剖学贴附,术后查体及头颅CT随诊,14例患儿头颅外观畸形消失,颅板萎缩恢复,预后良好.结论 小婴儿头皮血肿钙化由新生儿头皮血肿发展而来,通过及时的新生骨质切除骨膜贴附可治愈.预防小婴儿头皮血肿钙化的最好方法是及时行新生儿头皮血肿穿刺抽吸加压包扎. Abstract: Objective To explore the clinical features and surgical management of infantile calcified cephalohematoma.Methods A total of 14 infants with calcified cephalohematoma treated at our hospital from January 2011 to December 2012 were retrospectively analyzed.Their clinical features,operative procedures and outcomes were analyzed.Skin flap was opened under galea aponeurotica or periosteum by an arc incision.The blood in cyst was removed by aspiration through drilling a hole through calcified cephalohematoma.Neoformative abnormal bone was snipped off rapidly to reduce bleeding.Then periosteum was attached to atrophic bone.Periosteum and dura were protected throughout operation.All cases were followed up for 3 months to 2 years.Results Calcified cephalohematoma was a result of either failed absorption or no early aspiration.Their mean age was 2 months.The locations were at uni or bi-lateral parietal regions.Bone resection and periosteum sticking were employed.A key was restoring anatomical apposing of skull bone and periosteum.Skull deformity was corrected and cranial bone atrophy recovered.Conclusions Infantile calcified cephalohematoma may be cured by bone resection and periosteum sticking.And the best preventive method is early aspiration and pressure dressing. 所以,建议大家:新生儿头皮血肿要在2周内穿刺。穿刺感染的风险很小。河北省儿童医院小儿神经外科曹红宾

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曹红宾
曹红宾 副主任医师
河北省儿童医院 小儿神经外科
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