电脑塑形钛网颅骨修补术治疗颅脑外伤术后额颞部颅骨缺损  

Computer-aided shaping titanium mesh for the repair of large frontotemporal skull defect after traumatic brain injury

作　　者：骆健明[1] 赵泽林[1] 丁山[1] 

机构地区：[1]汕头大学医学院第二附属医院神经外科,515041

出　　处：《实用医学杂志》2010年第15期2734-2737,共4页The Journal of Practical Medicine

摘　　要：目的:探讨数字化电脑塑形钛网修补额颞部大面积颅骨缺损的效果及优缺点。方法:选取颅脑外伤术后遗留额颞大面积颅骨缺损的患者共126例,分两组,每组各63例,第一组使用手工塑形钛网进行颅骨修补,第二组使用数字化电脑塑形钛网进行颅骨修补。观察两种方法修补的优缺点。结果:与采用手工塑形钛网的第一组患者相比,采用数字化电脑塑形钛网行额颞颅骨修补的第二组患者手术时间缩短(P<0.05),钛钉用量减少(P<0.001),且术后满意度较高(P<0.05)。术后所有病例未见钛网松动。皮下积液、钛网翘起及颞肌疼痛是最常见的并发症,第一组共发生积液13例,钛网翘起10例,颞肌疼痛15例。第二组共发生积液4例,钛网翘起2例,颞肌疼痛4例,两组差异有显著性(P<0.05或P<0.01)。其他常见的并发症还有头皮感染、钛网外露、硬膜外血肿以及癫痫发作等。结论:采用数字化电脑塑形钛网进行额颞大面积颅骨缺损修补,其术后并发症明显少于手工塑形钛网,而且能很好还原患者的头形容貌,是颅骨修补理想的选择。Objective To analyze the effects of computer-aided shaping titanium mesh in the repair of large frontal-temporal skull defect. Methods From March 2005 to June 2009, 126 patients with frontal-temporal skull defect were enrolled in this study. They were divided into two groups, the first group treated with manual shaping titanium mesh and the second group with computer-aided shaping titanium mesh. The effects of these two approaches in the repair of large frontal-temporal skull defect were compared. Results There were no titanium-mesh loosening cases in both groups. Subcutaneous fluid collection, titanium mesh tilt and temporal muscle pain were the most common complications. There were 13 cases of effusion, 10 cases of titanium mesh tilt and 15 cases of temporal muscle pain in the first group. And in the second group, 4 cases of effusion, 2 cases of titanium mesh tilt and 4 cases of temporal muscle pain were observed. There were statistically difference between these two groups （P 〈 0.01 ）. Other common complications were infection of the scalp, the exposed titanium mesh, epidural hematoma, seizures and so on. Conclusion Comparing to manual remodeling titanium mesh, computer-aided shaping titanium mesh not only reduced post-operative complications, but also restored the patient＇s head appearance. It is an ideal choice for cranioplasty.

关 键 词：颅脑损伤 颅骨损伤 外科手术 计算机辅助 颅骨修补 电脑塑形钛网 

分 类 号：R651.1[医药卫生—外科学]