应用深低温保存自体颅骨治疗儿童继发性颅骨缺损的回顾性研究  

Cryopreservation of autologous cranial bone flaps for cranioplasty in children

作　　者：车东方 廖传鹏 王靖生[1] 刘悦琤 刘明刚[1] 臧冬东[1] 刘棋斌 陈乾[1] Che Dongfang;Liao Chuanpeng;Wang Jingsheng;Liu Yuecheng;Liu Minggang;Zang Dongdong;Liu Qibin;Chen Qian(Department of Neurosurgery,Shenzhen Children’s Hospital,Shenzhen 518038,China)

机构地区：[1]深圳市儿童医院神经外科,518038

出　　处：《中华神经创伤外科电子杂志》2021年第2期82-86,共5页Chinese Journal Of Neurotraumatic Surgery：Electronic Edition

基　　金：深圳市医学重点学科(2020-2024)(SZXK035)。

摘　　要：目的研究深低温保存自体颅骨修补术应用于儿童的治疗效果及影响因素分析。方法回顾性分析深圳市儿童医院神经外科自2013年7月至2020年12月收治的62例深低温保存自体颅骨并行颅骨修补术患儿的临床资料,术后1周内、3、6和12个月行颅脑CT检查并随访3年,统计自体颅骨修补术的并发症并分析其相关风险因素。结果深低温并终末消毒保存自体颅骨术后感染率为0%,11例患儿由于颅骨吸收而采用人工材料进行二次颅骨修补,平均二次修补时间为自体颅骨修补术后18个月。自体颅骨吸收术后6个月的相关风险因素分析结果显示,年龄、骨瓣面积、术区大面积脑软化是影响自体颅骨吸收的风险因素(P<0.05)。结论深低温保存自体颅骨修补术治疗儿童继发性颅骨缺损效果好,感染率低,能够避免或推迟进行人工材料二次修补。低龄患儿、骨瓣面积大、大面积脑软化是自体骨瓣吸收的风险因素。Objective To study the clinical effect and influencing factors of cryopreserved autologous skull bone repair in children.Methods The clinical data of 62 children who underwent autologous skull bone repair with cryopreservation from July 2013 to December 2020 were analyzed retrospectively.The CT examination was performed within 1 week,3,6,12 months after operation,and the follow-up was conducted for 3 years.The complications of autocraniectomy were summarized and the related risk factors were analyzed.Results The infection rate was 0%after cryopreservation and terminal disinfection preservation autologous skull bone.Eleven cases were repaired with artificial materials due to skull bone flap resorption.The average time of second repair was 18 months after the operation.The results of risk factors analysis at 6 months after the operation showed that age,bone flap area and large area of cerebral malacia were the risk factors affecting the resorption of autologous skull bone(P<0.05).Conclusion Cranioplasty with cryopreserved autologous skull bone in the treatment of children with secondary skull defect has good effect and low infection rate,which can avoid or delay the secondary repair of artificial materials.The risk factors of autogenous bone flap resorption were young children,large area of bone flap and large area of encephalomalacia.

关 键 词：自体颅骨瓣 小儿颅骨成形术 冷冻保存 再吸收 

分 类 号：R726.5[医药卫生—儿科]