儿童颅骨缺损早期修补的实践及探讨  

Clinical application of computer - assisted 3 - dimensional modeled titanium mesh in the repair of skull defects in children

作　　者：顾硕[1] 鲍南[1] 徐织[1] 

机构地区：[1]上海交通大学医学院附属上海儿童医学中心神经外科, 200127

出　　处：《中华神经外科杂志》2012年第10期1001-1004,共4页Chinese Journal of Neurosurgery

摘　　要：目的探讨儿童尤其是婴幼儿颅骨缺损早期修补的临床应用价值。方法2000—2010年上海儿童医学中心对19例颅骨缺损患儿采用计算机三维塑型钛网行早期颅骨缺损覆盖修补。患儿年龄22个月-13岁，平均年龄5．8岁；颅骨缺损2cm×5cm-12cm×12cm，均在颅骨缺损3个月后行颅骨缺损修复术。结果手术后切口均一期愈合。随访时间1～10年，钛网固定牢固，无浮动，无头皮刺痛、卡压等不适，外观无畸形，头面部正面观左右对称，效果满意率达100％。结论对儿童颅骨缺损进行早期修复，有利于儿童生理、心理的康复，修补年龄可提早到2岁。应用计算机三维塑型钛金属网覆盖修复儿童颅骨缺损，吻合精度高，对儿童颅骨生长无明显影响。Objective To investigate the clinical value of early repair of skull defects in young children. Methods Skull defects in 19 children were repaired in early time, with titanium mesh individually designed by computer - assisted 3D modeling. The mean age was 5.8 years （range, 2 to 13 years）. The size of defects ranged from 2 cm × 5 cm to 12 cm × 12 cm. Repair of the skull defects was performed at least 3 months after the injury. Thin - section helical computed tomography （CT） scanning was performed before the operation. Computer - assisted 3D skull reconstruction was performed to generate a 3D model for a true - to - original repair of the skull of the patient. A 3D modeled titanium mesh completely matching the defect was designed and produced to repair the skull defect. Results All patients achieved excellent results. Primary healing occurred in all patients. The duration of follow - up ranged from 1 to 10 years. The titanium mesh was stably fixed in all patients, no patient experienced stabbing pain in the scalp, and no entrapment occurred. In all cases, no deformity in the skull were noted, the head and face were overall symmetrical. The rate of satisfactory outcome was 100%. Conclusions Early repair of skull defects in young children is benefit to children＇ s physical, psychological rehabilitation. By selecting the appropriate repair method, operations can be performed on children at the smallest age of 2. Computer- assisted 3D modeled titanium meshes can be applied for the treatment of skull defects in young children, and it has no significant effect on the growth of the skull.

关 键 词：儿童 颅骨修补 三维塑型 钛网 

分 类 号：R651.1[医药卫生—外科学]