自体骨移植与人工骨移植材料修补颅骨缺损后的并发症  

Complications of skull repair with autologous and artificial bone grafts

作　　者：李建平[1] 杨琳[1] 秦毅 蒋振东[1] 卢巍[1] Li Jian-ping;Yang Lin;Qin Yi;Jiang Zhen-dong;Lu Wei(Department of Human Anatomy,Zunyi Medical College Zhuhai Campus,Zhuhai 519041,Guangdong Province,China;Department of Orthopedics,Zhuhai People’s Hospital,Zhuhai 519000,Guangdong Province,China)

机构地区：[1]遵义医学院珠海校区解剖学教研室,广东省珠海市519041 [2]珠海市人民医院脊柱骨科病区,广东省珠海市519000

出　　处：《中国组织工程研究》2018年第30期4794-4799,共6页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金(81760416):利用靶向神经移植术重建缺失肢体运动神经信息源及机制研究;遵义市科技计划项目(E-199):截肢下肢神经功能重建方法及神经康复机制研究~~

摘　　要：背景:国内对颅骨修补的最佳时机及不同颅骨移植材料引起的并发症少有报道。目的:比较自体与人工骨移植材料对颅骨修补并发症的影响。方法:纳入接受颅骨缺损重建治疗的患者62例,其中男40例,女20例,年龄(48.4±10.3)岁,根据骨移植材料不同分为自体骨移植组(n=12)、生物活性FRC组(采用生物活性玻璃纤维增强复合材料修复,n=12)、羟基磷灰石组(n=20)和其他材料组(包括聚醚醚酮、聚甲基丙烯酸甲酯、聚乙烯及钛材料,n=18)。颅骨修补后1,6,12个月对患者进行随访,比较各组术后并发症的发生率。结果与结论:(1)4组组内,开颅手术到修补手术时间间隔<3个月与>3个月的并发症发生率比较均无差异。4组间,开颅手术到修补手术时间间隔<3个月的并发症发生率比较无差异;自体骨移植组开颅手术到修补手术时间间隔>3个月的并发症发生率高于生物活性FRC组,其余组间两两比较无差异;(2)4组间颅骨修补后1,6个月正常愈合、次要并发症(术后需保守治疗)和主要并发症(需二次手术修复),以及12个月正常愈合和次要并发症发生率无差异;颅骨修补后12个月的主要并发症,自体移植组、其他材料组高于生物活性FRC组(P<0.05),其余组间两两比较无差异;(3)结果表明,生物活性玻璃纤维增强复合材料修补颅骨缺损后的远期并发症发生率低,有更好的应用前景。BACKGROUND:There are less domestic reports on the best timing for skull repair and the complications caused by different skull transplantation materials.OBJECTIVE:To compare the impact of autologous bone grafts and artificial bone grafts on the complications of skull repair.METHODS:Sixty-two patients undergoing skull repair,40 males and 20 females,aged(48.4±10.3)years,were included.According to different graft materials,the patients were divided into autologous bone graft group(n=12),bioactive FRC group(bioactive glass fiber reinforced composite,n=12),hydroxyapatite group(n=20)and the group of other materials(including polyetheretherketone,polymethylmethacrylate,polyethylene and titanium materials,n=18).Patients were followed for 1,6,12 postoperative months,and the incidence of postoperative complications was compared between groups.RESULTS AND CONCLUSION:(1)As regards the time interval from craniotomy to skull repair,in each group,there was no difference in the incidence rate of complications between the time interval of less than 3 months and of more than 3 months,while among the four groups,there was no difference in complication rates with the time interval of less than 3 months.The complication rate with the time interval of more than 3 months in the autologous bone graft group was higher than that in the bioactive FRC group,and there was no difference between other groups.(2)Among the four groups,there were no differences in the incidence rate of secondary complications(conservative treatment was needed after surgery)and major complications(secondary surgical repair was required)after normal healing of 1 and 6 months and the incidence rate of secondary complications after normal healing of 12 months.The incidence rate of major complications at 12 months after skull repair in the autologous bone graft group and other materials group was higher than that in the bioactive FRC group(P<0.05),and there was no difference between other groups.Overall,our findings reveal that the incidence rate of long-term complic

关 键 词：移植 颅骨修补术 自体骨移植 生物活性FRC 羟基磷灰石 国家自然科学基金 生物材料 骨移植 颅骨 手术后并发症 组织工程 

分 类 号：R318[医药卫生—生物医学工程]