聚维酮碘冷冻保存自体颅骨骨瓣回植修补颅骨缺损的临床研究  

The clinical study of povidone iodine cryopreservation technique in self-skull repairing operation

作　　者：庄明华[1] 罗成[2] 陈彬[2] 

机构地区：[1]汕头大学医学院第一附属医院龙湖医院神经外科,515041 [2]汕头大学医学院第一附属医院神经外科

出　　处：《中国医药》2015年第2期192-195,共4页China Medicine

摘　　要：目的探讨聚维酮碘冷冻保存自体颅骨骨瓣回植修补颅骨缺损的远期疗效。方法30例颅脑手术去骨瓣减压患者采取自愿形式，将术中取下的颅骨骨瓣用聚维酮碘冷冻保存，保存前用0.9%氯化钠注射液清洗骨瓣，然后行冲洗液细菌培养，待3-6个月后行颅骨缺损修补术;术后评估手术疗效。结果30例中1例出现伤口感染，行修补骨瓣取出术；1例因术后脑积水再次行脑室腹腔分流术致颅内感染死亡；1例因术后5 h复查CT发现硬膜外血肿，行硬膜外血肿清除术；1例出现少量头皮下积液，自行吸收；其余26例无感染、硬膜下或硬膜外血肿、皮瓣坏死等自体颅骨骨瓣回植修补颅骨缺损手术成功率为86.7%（26/30）。术后复查头颅CT对位良好，颅骨解剖复位。随访1个月-5年，均恢复良好，没有钛板等其他修补材料和其他自体颅骨保存回植法的并发症，复查CT示部分骨瓣与骨窗边缘骨性愈合。结论聚维酮碘冷冻保存自体颅骨骨瓣回植修补颅骨缺损是一种可靠、安全、便捷的方法。Objective To study about the longterm effect of povidone iodine cryopreservation technique in selfskull repairing operation. Methods Totally 30 patients taken craniocerebral surgical operation participated in this research voluntarily. The skull bone flap was removed during the neurosurgery and was cryopreserved with povidone iodine preservative liquid. Before preservation, the skull bone flap was cleaned with 0.9% sodium chloride solution, and the liquid after washing was collected for microbiological analysis. The skull bone flap would be cryopreserved for 3 to 6 months and used for selfskull repairing operation. Results In total 30 cases, wound infection occured in 1 case and the repaired skull bone flap was removed later; 1 dead case had intracranial infection after the ventricle peritoneal drainage treating postoperative hydrocephalus; postoperative extradural hematoma was in 1 case via CT examination 5 hours after the original neurosurgery and the patient received the removal operation of epidural hematoma; small amount of effusion under the scalp appeared in 1 case and selfabsorption was observed later; no infection, subdural or extradural hematoma, skin flap necrosis were observed in other 26 cases. The postoperative CT check showed the good skull anatomical reset. According to the followup from 1 month to 5 years after the surgery, all patients well recovered. Conclusion The method of applying povidone iodine cryopreservation technique to preserve the skull bone flap for selfskull repairing is reliable, safety and convenient.

关 键 词：颅骨缺损 自体颅骨骨瓣 聚维酮碘冷冻保存 

分 类 号：R683[医药卫生—骨科学]