3D打印数字化塑形聚醚醚酮和钛网颅骨修补后并发症异同和应用改进  

Complication comparison and application improvement of 3D-printed plastic polyetherketone and titanium mesh cranioplasty

作　　者：胡均贤 赵德英 王雷[1] 黄明火 吴雅兰 陈劲草 刘征 Hu Junxian;Zhao Deying;Wang Lei;Huang Minghuo;Wu Yalan;Chen Jincao;Liu Zheng(Huanggang Central Hospital of Yangtze University,Huanggang 438000,Hubei Province,China;Zhongnan Hospital,Wuhan University,Wuhan 430000,Hubei Province,China)

机构地区：[1]长江大学附属黄冈市中心医院,湖北省黄冈市438000 [2]武汉大学中南医院,湖北省武汉市430000

出　　处：《中国组织工程研究》2022年第21期3327-3331,共5页Chinese Journal of Tissue Engineering Research

摘　　要：背景:颅骨修补材料种类繁多,但目前仍然没有哪种材料能在生物相容性、性价比等各方面性能上全部满足临床需要。目的:分析3D打印数字化塑形聚醚醚酮和钛网修补颅骨缺损的术后并发症差异,针对并发症明确改进方向。方法:回顾性分析长江大学附属黄冈市中心医院2014年6月至2021年6月收治的207例颅骨缺损患者,男157例,女50例,年龄16-68岁,其中42例使用聚醚醚酮修补材料,165例使用钛网修补材料。术后第3周,进行额颞顶区缺损区塑形满意度调查;术后随访统计并发症发生情况。结果与结论:(1)聚醚醚酮组32例进行额颞顶区缺损修补,塑形满意度为56.3%;钛网组117例进行额颞顶区缺损修补,塑形满意度为75.2%,两组塑形满意度比较差异有显著性意义(P<0.05);(2)聚醚醚酮组42例中14例发生并发症,其中皮下积液12例(28.6%)、癫痫1例、额部螺钉固定处隆起疼痛1例,并发症发生率为33.3%;钛网组165例中28例发生并发症,其中皮下积液15例(9.1%)、癫痫7例、颅内感染2例、材料外露2例、颅内血肿1例、材料松动1例,并发症发生率为17.0%,两组间皮下积液及总并发症发生率比较差异有显著性意义(P<0.05);(3)结果表明,额颞顶区骨质缺损处采用钛网修补较聚醚醚酮材料修补美观、满意度更高,聚醚醚酮材料应用于颅骨修补的主要改进方向是降低术后皮下积液的发生率。BACKGROUND:There are many kinds of skull repair materials,but there is still no one material in high biocompatibility,high cost-effective and low incidence of complications in all aspects of clinical needs.OBJECTIVE:To analyze the difference in postoperative complications of 3 D printed plastic polyetherketone and titanium mesh cranioplasty,and point out the improvement directions.METHODS:Data of 207 patients undergoing cranioplasty in Huanggang Central Hospital of Yangtze University from June 2014 to June 2021 were retrospectively analyzed,including 157 males and 50 females,at the age of 16-68 years old.Among them,42 patients were treated with polyetheretherketone and 165 patients were treated with titanium mesh.The satisfaction survey of the reconstruction of the frontotemporal parietal defect area was carried out at 3 weeks after the operation.Complications were analyzed during postoperative follow-up.RESULTS AND CONCLUSION:(1)There were 32 cases of skull defect repaired with polyetheretherketone,with shaping satisfaction of 56.3%,and 117 cases of skull defect repaired with titanium mesh,with shaping satisfaction of 75.2%.Significant differences in shaping satisfaction were found between the two groups(P<0.05).(2)Complications occurred in 14 of 42 cases in the polyetheretherketone group,including 12 cases of subcutaneous hydrops(28.6%),1 case of epilepsy,and 1 case of forehead screw fixation swelling pain;with a complication rate of 33.3%.Among the 165 cases in the titanium mesh group,28 cases had complications,including 15 cases of subcutaneous hydrops(9.1%),7 cases of epilepsy,2 cases of intracranial infection,2 cases of material exposure,1 case of intracranial hematoma,1 case of material loosening,with a complications rate of 17.0%.There was a significant difference in the incidence of subcutaneous hydrops and total complication rate between the two groups(P<0.05).(3)It is concluded that titanium mesh was better than polyetherketone mesh in repairing bone defect of frontotemporal parietal region,with a high

关 键 词：生物材料 聚醚醚酮 钛网 颅骨修补 颅骨缺损 数字化塑形技术 并发症 

分 类 号：R459.9[医药卫生—治疗学] R319[医药卫生—临床医学]