探讨静脉窦区颅骨凹陷性骨折的治疗策略。

回顾性分析福建医科大学福总临床医学院（第九〇〇医院）神经外科自2014年10月至2019年10月收治的静脉窦区凹陷性颅骨骨折患者的临床资料，观察保守治疗、骨折区手术及远隔部位手术的临床疗效。

研究共纳入35例患者，其中骨折区主要位于上矢状窦前1/3段14例，位于上矢状窦中1/3段9例，位于上矢状窦后1/3段11例，跨左侧横窦1例。保守治疗9例，均治愈出院。行手术治疗26例，其中8例行凹陷性骨折远隔区域硬膜下血肿清除+去骨瓣减压术，18例行骨折片整复及同部位硬膜外血肿清除术。26例手术患者中5例死亡，21例患者临床症状和神经功能均在较短时间内改善。

对于静脉窦区凹陷性颅骨骨折患者，应选择谨慎的手术方式及时机，有效控制手术出血，尽可能修补静脉窦壁的破损，并降低后期静脉循环障碍的发生率。

To explore the treatment strategy for depressed skull fracture in the venous sinus region.

The clinical data of 35 patients with venous sinus depressed skull fractures admitted to Neurosurgery Department of Fujian Medical University Fuzong Clinical College (the 900^th Hospital) from October 2014 to October 2019 were retrospectively analyzed. The clinical efficacy of conservative treatment, fracture surgery and distal surgery was observed.

In 35 cases, the fracture zone mainly spans the anterior 1/3 segment of superior sagittal sinus in 14 cases, the middle 1/3 segment of superior sagittal sinus in 9 cases, the posterior 1/3 segment of superior sagittal sinus in 11 cases, and across the left transverse sinus in 1 case. Nine of conservative treatment were cured and discharged. Surgical treatment was performed in 26 cases, including 8 cases of subdural hematoma removal + decompression craniectomy in the distal region of depressed fracture, and 18 cases of fracture restoration and epidural hematoma removal at the same site. Of the 26 surgical patients, 5 died. The clinical symptoms and neurological function of 21 patients were improved in a relatively short period of time.

For patients with a depressed skull fracture in the venous sinus area, careful surgical methods and timing should be selected to effectively control surgical bleeding, repair venous sinus wall damage as much as possible, and reduce the incidence of delayed venous circulation disorders.