数字化塑形与手工塑形钛网在大面积颅骨缺损修补应用中的比较  

Digital shaped titanium mesh versus manual shaped titanium mesh in cranioplasty of large skull defects

作　　者：刘寿堂[1] 李连[1] 韦红恩[1] 朱达[1] 叶俊[1] 于路[1] 唐玺和[1] 赵黎明[1] 

机构地区：[1]柳州市人民医院神经外科,广西壮族自治区柳州市545001

出　　处：《中国组织工程研究与临床康复》2008年第52期10289-10292,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:计算机辅助设计个体化塑形钛网修补大面积额颞顶部颅骨缺损能最大限度地达到生理解剖形态上的成型。目的:对比观察数字化塑形钛网与手工塑形钛网修补大面积额颞顶颅骨缺损塑形效果。设计、时间和地点:对比观察,于2004-01/2008-07广西柳州市人民医院神经外科完成。对象:2004-01/2008-07广西柳州市人民医院神经外科收治重型颅脑损伤大骨瓣减压术后大面积额颞顶部颅骨缺损患者62例,男43例,女19例;年龄16～58岁。方法:34例重型颅脑损伤大骨瓣减压术后大面积额颞顶部颅骨缺损患者采用手工塑形钛网修补,28例颅骨缺损患者采用计算机辅助设计、计算机辅助制造技术和快速自动成型技术,将钛网制成个性化颅骨修复体进行修补。主要观察指标:两种方法手术时间、钛钉用量、塑形效果及术后并发症比较。结果:数字化塑形钛网组手术时间比手工组缩短约30min(P<0.05);数字化塑形组钛钉用量比手工塑形组用量少(P<0.05)。数字化塑形组钛修复体塑形曲度及边缘与缺损处吻合良好,两侧对称,达到生理解剖形态上的成型,外观满意率(96.5%)优于手工塑形组满意率。数字化塑形组2例出现皮下积液。手工塑形组3例出现皮下积液,9例有头皮刺痛现象,4例咀嚼疼痛,2例钛网边缘翘起。结论:采用数字化塑形钛网对大面积颅骨缺损进行修复,与传统手工塑形相比,具有手术步骤简单,塑形的钛修复体曲度自然,达到生理解剖形态上的成型、术中无需再加工,术后并发症少等优势。BACKGROUND： Individualized modeled titanium mesh with computer-aided design （CAD） can best achieve physiologic and anatomical molding during large defect of skull in the frontotemporal area. OBJECTIVE： to To study compare and observe the cranioplasty effect of use of individuallyized modeled titanium mesh with computer-aided design （CAD） and manual modeled dtanium mesh for cranioplasty of large skull defects in the frontotemporal area. DESIGN, TIME AND SETTING： Comparative observation was performed at the Department of Neurosurgery, Liuzhou People＇s Hospital between January 2004 and July 2008. PARTICIPANTS： Sixty-two patients undergoing cranioplasty were selected including 43 males and 19 females aged 16 58 years. METHODS： CAD/CAM and rapid shaping technique were applied to make individual prefabricated titanium mesh.Cranioplasty was carried out in 28 patients with large parietal skull defects in the frontotemporal area.And 34Thilty-four patients with traditional manual shaping served as control group; 28 patients with the mesh designed by CAD/CAM and rapid shaping technique. MAIN OUTCOME MEASURES： oup .Shaping quality, operation time, consumption of titanium screws, complications and satisfactory rate after operation were compared. RESULTS： Compared with traditional manual shaping group, the operation time of CAD group was about 30 minutes shorter （P 〈 0.05）, and the titanium screws were fewer （P 〈 0.05）. The shapes of CAD titanium prosthesis were smooth and with natural curve. With the beautiful and symmetric looking the satisfactory rate of patients reached 96.5%, higher than manual shaping group （82.4%, P 〈 0.05）. No other complications occurred in the CAD group, but transient subcutaneous fluid in two patients. Of 34 patients with manual shaped titanium mesh, subcutaneous fluid occurred in 3 patients, scale-pricking pain in 9 patients, chewing-pain in 4 patients, and titanium mesh pustuting in 3 patients. CONCLUSION： Compared with the traditional manual shaping, th

关 键 词：计算机辅助设计技术 颅骨缺损 钛网 

分 类 号：R318[医药卫生—生物医学工程]