仿生矿化胶原颅骨修补术:儿童颅骨修补的新方法  

Cranioplasty by biomimetic hydroxyapatite collagen composites:a new method of cranioplasty in children

作　　者：陈拓宇[1] 张玉琪[2] 王硕 王秀梅[3] CHEN Tuo-yu;ZHANG Yu-qi;WANG Shuo;WANG Xiu-mei(Department of Neurosurgery,Beijing Tsinghua Changgung Hospital,Affiliated Hospital of Tsinghua University,Beijing 102218,China;Department of Neurosurgery,Tsinghua University Yuquan Hospital,Beijing 100040,China;School of Materials Science and Engineering(SMSE),Tsinghua University,Beijing 100084,China)

机构地区：[1]清华大学附属北京清华长庚医院神经外科,102218 [2]清华大学玉泉医院神经外科,北京100040 [3]清华大学材料学院,北京100084

出　　处：《中国现代神经疾病杂志》2024年第10期827-833,共7页Chinese Journal of Contemporary Neurology and Neurosurgery

基　　金：国家重点研发计划项目(项目编号:2023YFC2412305)。

摘　　要：目的探寻颅骨缺损患儿行颅骨修补的新材料和新方法。方法与结果纳入2020年1月至2022年4月在清华大学玉泉医院行颅骨修补术的40例颅骨缺损患儿,根据颅骨缺损原因、部位和面积,采用清华大学自行研发的3种同源异构的仿生矿化胶原骨材料,即多孔材料(pMC)、致密材料(cMC)和双相复合材料(bMC)修补颅骨,均手术顺利,术后未发生出血、感染等严重并发症。术后随访3个月至1年,患儿头部外形正常,切口愈合良好,复查CT显示仿生矿化胶原骨材料植入体均无移位,部分实现影像学融合,pMC CT值为300~400 HU,cMC CT值为700~900 HU,且随时间推移CT值接近正常骨组织。结论通过不同类型仿生矿化胶原骨材料进行个体化颅骨修补术,验证这种材料可模仿天然骨成分及仿生结构,具有良好的生物相容性和成骨诱导能力,临床应用前景广阔。Objective To research new methods and materials for cranioplasty in children with various types of skull defects.Methods and Results A total of 40 childrens with different locations,sizes and reasons of skull defects underwent surgery using 3 classes of homogeneous yet heterogeneous biomimetic hydroxyapatite collagen bone materials developed by Tsinghua University.These include porous mineralized collagen scaffolds(pMC),compact mineralized collagen scaffolds(cMC),and biphasic mineralized collagen composite scaffolds(bMC).Cranioplasty was successful in all cases,with no serious postoperative complications and good recovery outcomes.After 3 months to one year of follow⁃up,there was no displacement of the implants,the shape of the head was normal,the incisions healed well.Reexamination CT showed that the biomimetic hydroxyapatite collagen bone material implants were not shifted,and imaging fusion was partially achieved.The pMC CT HU⁃value was 300-400 HU,and the cMC CT HU⁃value was 700-900 HU,and the CT HU⁃value was close to normal bone tissue over time.Conclusions The use of different types of biomimetic hydroxyapatite collagen composites allows for personalized cranial reconstruction based on individual needs,and has been proven to possess good bio⁃compatibility and osteoinductive capacity.This approach is thus promising for research and clinical applications,with significant value.

关 键 词：颅骨 骨代用品 仿生矿化胶原(非MeSH词) 颅骨修补术(非MeSH词) 骨再生 儿童 

分 类 号：R726.5[医药卫生—儿科]