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作 者:王兆铭[1,2,3] 周守理 田奉宸
机构地区:[1]天津市第二中心医院脑系科 [2]天津市冶金局材料研究所 [3]天津市整形外科研究所
出 处:《中国修复重建外科杂志》1998年第6期347-349,共3页Chinese Journal of Reparative and Reconstructive Surgery
基 金:天津市卫生局科研基金
摘 要:为解决硅橡胶涤纶丝网颅骨修补用丝线固定手术操作繁琐、固定不牢等问题,先将镍钛形状记忆合金锔钉置于0℃~3℃水中,锔钉变软,用撑开器将其臂杆拉长3mm,锔钉的两脚与臂杆间夹角加大成直角。然后将锔钉的两脚钉入颅骨与成形片上的两个钻孔中,用热盐水纱布热敷锔钉,锔钉遇热立即恢复原状,并产生恢复力,将颅骨和成形片牢固锔在一起。1987年8月~1995年8月,临床应用这种锔钉行颅骨修补101例,随访到100例,随访时间为1年~8年。结果,98例术后无不良反应,2例额骨缺损者,术后第一天发现患侧额肌运动障碍,术后2个月恢复正常。无一例发生锔钉松动和成形片错位。认为,镍钛形状记忆合金锔钉用于硅橡胶涤纶丝网颅骨修补有以下优点:①手术操作简便;②固定牢固;③术后组织反应轻;④合并症少;⑤整形效果良好;⑥对颅脑CT及核磁共振检查无干扰;Fixation of silicon polyester fiber network on skull defect was usually difficult to handle and the fixation was unstable. In order to solve these problems, NiTi shape memory alloy cramp was adopted and 101 patients with skull defects were selected for this clinical trial. Among them, there were 79 males and 22 females, and the age ranged from 12~55 years old. The area of skull defect ranged from 3 cm×4 cm to 10 cm×16 cm. All of these patients received repairing of the skull defects by silicon polyester fiber network which was fixed by NiTi memory alloy cramps. After operation, there was no complication. One hundred patients were followed up for 1~8 years, in which 97 cases returned to their normal work, and only 2 cases had a transient dysfunction of frontal muscle for 2 months. In addition, There were no loosening of the cramps, displacement of plastic network and malignant degeneration, The NiTi shape memory alloy cramps had the following advantages: ①simple operative procedure; ②rigid fixation; ③mild postoperative tissue reaction; ④few postoperative complication; ⑤favorable effect of skull repair; ⑥no interference with CT and MRI image; ⑦no carcinogenicity.
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