127例自体颅骨瓣普通冰箱冷冻保存后再回植体会  

Replantation of 127 cases of Autologous skull flap after Freezing in Regular Refrigerator

作　　者：巨清[1] 郭育辉[1] 王桂林[1] 哈米提[1] 

机构地区：[1]新疆伊犁州友谊医院,新疆835000

出　　处：《安徽卫生职业技术学院学报》2012年第5期31-32,共2页Journal of Anhui Health Vocational & Technical College

摘　　要：目的：探讨自体骨瓣普通冰箱冷冻保存后再回植在临床中的应用。方法：总结某医院应用普通冰箱于-20℃冷冻保存洗净后严格无菌包裹颅骨瓣,自体颅骨修补时在常温解冻后颅骨瓣钻细孔数个,再分别用碘伏溶液及庆大霉素盐水浸泡并反复充分冲洗后复位于原骨窗。结果：术后6个月~1年对病人行颅脑CT及X线检查复查：124例患者达到一期愈合,骨瓣解剖复位,颅骨未见异常改变,可见少量骨痂生长,外观未见骨质吸收,外形美观。2例患者术后1年出现溶骨,骨瓣缩小浮动,行二次手术取出骨瓣,同期钛网修补;1例患者因伤口裂开骨瓣外露发生感染,经换药引流无效,行二次手术取出骨瓣并4个月后再行钛网修补术,术后恢复良好;7例患者出现皮下积液行1~3次穿刺抽吸加压包扎后一期愈合;合并脑积水患者积水改善明显。结论：普通冰箱冷冻保存的自体颅骨瓣可以安全、可靠地用于颅骨成形术,而且成形效果理想,不变形,少排异,外观上更接近解剖学特点,病人心理容易接受,尤其价廉,经济适用。Objective： to discuss the clinical application of replantation of autologous skull flap after freezing in regular refrigerator.Method： From January 2000 to May 2009 in our hospital,skull flap was cleaned and aseptically wrapped after stored-20℃ in regular refrigerator.During autologous skull flap repair,pores were made after normal temperature defrosting,skull flap was immersed in povidone iodine and gentamycin sulfate brine,and then resetted to the original bone window after being wased thorougly.Result： Brain CT and X-ray check were made from 6 months to 1 year after operation.124 patients reached A healing stage,2 patients occurred osteolysis and narrow the floating bone flap after 1 year,who were operated for the second time to take out skull flap and simultaneous repair with titanium mesh was made.1 case was found infectious due to wound dehiscence and exposed bone flap,who was given second surgery to take out skull flap and titanium mesh repair after 4 month because dressing drainage proved ineffective.7 cases occurred subcutaneous effusion and cured after 1 to 3 times of aspiration pressure bandage.Patients with complication of hydrocephalus improved significantly.Conclusion： Autologous skull flap freezed in regular refrigerator can be safely and reliably used for cranioplasty,which proves desirable forming,no deformation,less rejection,close anatomical characteristics,easy to accept on the part of the patients,low in price.

关 键 词：自体颅骨瓣 普通冰箱冷冻保存 再回植 

分 类 号：R651.1[医药卫生—外科学]