计算机辅助设计个体化塑形钛网修补颅骨缺损  

Modeled Titanium Mesh for Repair of Skull Defect with Computer-assisted Design

作　　者：张合林[1] 李玉强[1] 齐再利[1] 田爱民[1] 展如才[1] 

机构地区：[1]济南市济南市第三人民医院神经外科,山东省250101

出　　处：《组织工程与重建外科杂志》2009年第5期280-282,共3页Journal of Tissue Engineering and Reconstructive Surgery

基　　金：济南市卫生局科研基金(2004-36)

摘　　要：目的探讨计算机辅助设计个体化塑形钛网在颅骨修补术中的临床价值。方法126例颅骨缺损患者,采用随机双盲法分成两组:计算机塑形组66例,每例患者术前利用CT扫描获取整个颅骨及缺损部位的三维数据,利用计算机辅助设计软件重建颅骨三维模型,根据模型计算缺损面积,设计剪切出塑形钛网、消毒备用,术中将塑形钛网根据解剖结构使用钛钉固定于缺损部位;传统手工组60例,采用术中手工塑形的方法修补颅骨缺损。分析两组住院天数、手术时间、钛钉使用量、病人对成形术后头部外形的满意度指标。结果计算机塑形组平均住院天数16.28±2.12d,平均手术操作时间110.06±20.38min,钛钉使用量6.6±0.7枚,对塑形后外观满意9.2±0.9分。传统手工组平均住院天数17.56±4.57d,平均手术操作时间153.47±40.88min,钛钉使用量12.78±3.69枚,对塑形后外观满意度5.8±1.6分。结论个体化计算机三维塑型钛网修补颅骨缺损能够缩短手术时间,减少钛钉使用量和术后并发症,提高颅骨成形满意度。具有良好的推广应用价值。Objective To evaluate the clinical value of individual computer-assisted design of titanium mesh for cranioplasty. Methods From January 2005 to December 2008, 126 patients with skull defects were assigned to two groups randomly： In group 1, 66 patients were studied with computerized tomography （CT） to collect the 3D computer data of each patient＇s full skull and the defect before operation by using computer-assisted designation software to devise 3D topography of skull and defect was built according to the image. Corresponding titanium mesh mould was built and shaped titanium mesh were fixed on defects by titanium screws. In group 2 were traditional handwork shaping was used in 60 patients. The following aspects were analyzed and compared between two groups： average number of days hospitalized, operative time, the number of titanium screws used, satisfaction level on shaping and complications after operation. Results Group 1 showed that each patient took 16.28±2.12 days hospitalization, 110.06±20.38 minutes operation time, 6.6±0.7 titanium screws used, 9.2±0.9 value on satisfaction. However, conversely, Group 2 showed that each patient took 17.56±4.57 days hospitalization, 153.47±40.88 minutes operation time, 12.78±3.69 titanium screws used,and only 5.8±1.6 value on satisfaction. Conclusion Individually 3D modeled titanium mesh with computer-assisted design for repair of skull defect could shorten the operation time, reduce the number of titanium screws used, raise patients＇ satisfaction level and reduce complications after operation. It＇s a practical method.

关 键 词：颅骨缺损 颅骨成形 钛网 计算机辅助设计 

分 类 号：R628[医药卫生—整形外科]