颅骨修补治疗颅脑创伤术后颅骨缺损的时机与材料选择  

Timing and material for cranioplasty in patients with posttraumatic skull defects

作　　者：陈彧 朱园润 温良[3] 杨小锋[3] Chen Yu;Zhu Yuanrun;Wen Liang;Yang Xiaofeng(First Clinical Medicine,Zhejiang University School of Medicine,Hangzhou 310058,China;Emergency and Trauma Center,International Medical Center,First Affiliated Hospital,College of Medicine,Zhejiang University,Hangzhou 310003,China;Department of Neurosurgeryy First Affiliated Hospital,College of Medicine,Zhejiang University,Hangzhou 310003,China;Department oj Critical Care,903rd Hospital of PLA,Hangzhou.310003,China)

机构地区：[1]浙江大学医学院第一临床医学院,杭州310058 [2]浙江大学医学院附属第一医院急诊创伤中心,杭州310003 [3]浙江大学医学院附属第一医院神经外科,杭州310003 [4]联勤保障部队第903医院重症医学科,杭州310003

出　　处：《中华创伤杂志》2020年第4期360-365,共6页Chinese Journal of Trauma

摘　　要：颅骨缺损是颅脑创伤患者常见的后遗症,多由去骨瓣减压术等原因导致。创伤性颅骨缺损除导致脑组织在外界压力下出现变形及移位外,对脑血流、脑部代谢及脑脊液循环均有影响,可产生对侧轴外积血或积液、脑组织灌注减低、代谢紊乱、脑电活动紊等病理改变。颅骨修补能够改善脑的血供与代谢,有助于纠正脑脊液循环。对于颅脑创伤去骨瓣减压术后导致的颅骨缺损,尽早行颅骨修补术已经成为越来越多神经外科医师的选择。因此,笔者就颅骨修补治疗颅脑创伤术后颅骨缺损的时机与材料选择作一综述,以梳理相关研究进展,为临床实践提供一定启发与借鉴。Skull defect is commonly seen after traumatic brain injury and is often caused by decompressive craniectomy.Despite from pressure induced deformation or translocation,traumatic skull defect can also lead to multiple pathological influences to the brain,including cerebral blood flow or metabolism reduction,cerebrospinal fluid circulation disturbance,contralateral hematoma or effusion,and cerebral electrical activity changes.Cranioplasty can improve cerebral perfusion and metabolism as well as to support the rectification of cerebrospinal fluid circulation.Currently,early cranioplasty has been well accepted by neurosurgeons for the treatment of skull defect after decompressive surgery for traumatic brain injury,but the exact time point is still under debate and requires further clinical evidence.Therefore,the authors review the research progress of timing and material choices for cranioplasty of patients with skull defect after traumatic current researches,so as to provide possible inspiration for clinical practice.

关 键 词：颅脑损伤 颅骨 颅骨修补 

分 类 号：R651.1[医药卫生—外科学]