应用计算机辅助设计和制作的聚醚醚酮修补材料行颅骨成形术的临床观察  

Clinical observation of CAD/CAM polyetheretherketone(PEEK) prostheses in cranioplasty

作　　者：乔梁[1] 王汉东[1] 宋玥 王笑亮[1] 唐超 丛子翔[1] 马驰原[1] QIAO Liang;WANG Han-dong;SONG Yue;WANG Xiao-liang;TANG Chao;CONG Zi-xiang;MA Chi-yuan(Department of Neurosurgery,Jinling Hospital,Clinical School of Medical School,Nanjing University,Nanjing Medical University,Nanjing 210002,China)

机构地区：[1]东部战区总医院神经外科南京大学医学院,南京医科大学

出　　处：《创伤外科杂志》2019年第11期805-807,共3页Journal of Traumatic Surgery

基　　金：江苏省科教强卫工程医学重点学科(ZDXKB2016023)

摘　　要：目的探讨计算机辅助设计和制作(CAD/CAM)的聚醚醚酮(PEEK)修补材料在颅骨成形术中的治疗效果及并发症情况。方法回顾性分析东部战区总医院神经外科2017年2月-2018年12月收治的使用PEEK材料治疗颅骨缺损患者23例,男性13例,女性10例;年龄17~63岁,平均38.22岁。左侧缺损7例,右侧12例,双侧4例(其中3例每人用2块PEEK材料,1例双侧额部颅骨缺损患者使用1块PEEK材料)。分析颅骨缺损原因、缺损时间、术后并发症及临床效果等。结果23例患者均治愈出院,无感染及死亡病例,7例出现皮下积液,经抽吸及加压包扎后皮下积液吸收出院。切口均甲级愈合。术后随访10~30个月,平均19个月;无迟发性切口感染及植入修补材料外露或凹陷,无修正手术和修补材料去除病例。结论计算机辅助设计和制作的PEEK修补材料与颅骨完美契合,外形美观,组织相容性良好,无排异反应;应用PEEK材料颅骨成形术,早期并发症为头皮下积液,随访无迟发并发症。Objective To study the application and outcomes of Computer Aided Design and Computer Aided Manufacturing(CAD/CAM)polyetheretherketone(PEEK)materials in cranioplasty.Methods Data of 23 patients with skull defect who received cranioplasty with PEEK in Jinling Hospital from Feb.2017 to Dec.2018.were retrospectively reviewed.There were 13 males and 10 females,with an average age of 38.22 years(range,17-63 years).Seven patients were with defect on the left,and 12 patients wereon the right,and 4 patients were with bilateral defect(3 patients received 2 pieces of PEEK materials,and 1 patient with bilateral frontal skull defect received 1 piece of PEEK materials).The cause and duration of cranial defect,postoperative complications and clinical outcomes were analyzed.Results All the 23 patients were cured and discharged,without infection or death case.Seven patients developed subcutaneous effusion,and the effusion disappeared after aspiration and pressure bandaging.The wounds were healed well.The patients were followed up for 10-30 months with an average of 19 months.There was no delayed infection,no plant explosion or depression.No patient required revision surgery or removed the PEEK prosthesis.Conclusion CAD/CAM PEEK prosthesis fit perfectly with the skull with good cosmetics outcome and histological compatibility,without foreign body rejection reaction.Its early complication is subcutaneous effusion,and no other complication at later stage was found.

关 键 词：颅骨缺损 聚醚醚酮 颅骨成形术 头皮下积液 

分 类 号：R651.11[医药卫生—外科学]