自固化磷酸钙骨水泥在显微血管减压术颅骨重建中的应用价值  

Application value of self-setting calcium phosphate bone cement in cranioplasty during microvascular decompression

作　　者：李洋[1] 石海亮[1] 曹铂杨 张阔[1] 都毅辉 王银占 王永宇 史皓威[1] 钱涛[1] Li Yang;Shi Hailiang;Cao Boyang;Zhang Kuo;Du Yihui;Wang Yinzhan;Wang Yongyu;Shi Haowei;Qian Tao(Department of Neurosurgery,Hebei General Hospital,Shijiazhuang 050051,China;Hebei Medical University,Shijiazhuang 050051,China)

机构地区：[1]河北省人民医院神经外科,石家庄050051 [2]河北医科大学,石家庄050051

出　　处：《中华神经外科杂志》2025年第2期175-180,共6页Chinese Journal of Neurosurgery

摘　　要：目的探讨自固化磷酸钙骨水泥在经乙状窦后入路显微血管减压术颅骨重建中的应用价值。方法本研究为病例-对照研究。回顾性分析2019年4月至2022年2月河北省人民医院神经外科收治的127例行显微血管减压术患者的临床资料,其中原发三叉神经痛11例,舌咽神经痛1例,面肌痉挛115例。采用自固化磷酸钙骨水泥进行完全颅骨修补者共63例(自固化磷酸钙组),采用钛网进行不完全颅骨修补者64例(钛网组)。手术效果采用手术塑形满意比率、住院时长、术后2年随访时的局部疼痛和塌陷情况进行评估,并记录术后并发症(包括脑脊液漏和颅内感染)的发生情况。结果与钛网组相比,自固化磷酸钙组患者的塑形满意比率更高[分别为92.06%(58/63)和78.13%(50/64)],住院时长更短[分别为(9.11±1.99)d和(10.61±2.75)d],术后2年切口局部塌陷[分别为46.03%(29/63)和71.87%(46/64)]和术后2年切口疼痛比率[分别为7.94%(5/63)和56.25%(36/64)]更低,差异均有统计学意义(均P<0.05)。两组患者发生脑脊液漏、颅内感染以及行术后腰椎穿刺比率的差异均无统计学意义(均P>0.05)。自固化磷酸钙组依据病原学结果诊断颅内感染的比率小于钛网组[分别为1.59%(1/63)和12.50%(8/64),P=0.017]。结论与采用钛网进行经乙状窦后入路显微血管减压术中颅骨重建相比,采用自固化磷酸钙骨水泥可在不增加并发症的前提下提升手术效果,值得在临床上推广应用。ObjectiveTo explore the application value of self-setting calcium phosphate bone cement(CPC)in cranioplasty during microvascular decompression(MVD)via the retrosigmoid approach.MethodsThis was a case-control study.A retrospective analysis was conducted on the clinical data of 127 patients who underwent MVD at the Department of Neurosurgery,Hebei Provincial People′s Hospital from April 2019 to February 2022.Among these patients,11 had primary trigeminal neuralgia,1 had glossopharyngeal neuralgia,and 115 had hemifacial spasm.A total of 63 cases underwent complete cranial bone repair using self-setting CPC(self-setting calcium phosphate group),while 64 cases underwent incomplete cranial bone repair using titanium mesh(titanium mesh group).The surgical outcomes were evaluated based on the surgical shaping satisfaction rate,length of hospital stay,and local pain and depression status at the 2-year postoperative follow-up.Postoperative complications,including the occurrence of cerebrospinal fluid leakage and intracranial infections,were also documented.ResultsCompared with the titanium mesh group,the self-setting calcium phosphate group had a higher surgical shaping satisfaction rate[92.06%(58/63)vs.78.13%(50/64)],shorter hospital stay(9.11±1.99 days vs.10.61±2.75 days),and lower rates of local depression at the surgical site 2 years postoperatively[46.03%(29/63)vs.71.87%(46/64)]and postoperative incision pain[7.94%(5/63)vs.56.25%(36/64)].The differences between the two groups were statistically significant(all P<0.05).The differences in the rates of cerebrospinal fluid leakage,intracranial infection,and lumbar puncture between the two groups were not statistically significant(all P>0.05).The proportion of intracranial infections diagnosed based on microbiological findings was lower in the self-setting calcium phosphate group compared to the titanium mesh group[1.59%(1/63)vs.12.50%(8/64),P=0.017].ConclusionCompared with patients undergoing skull reconstruction with titanium mesh during microvascular decompression v

关 键 词：显微血管减压术 面部单侧痉挛 三叉神经痛 自固化磷酸钙骨水泥 颅骨重建 治疗结果 手术后并发症 

分 类 号：R47[医药卫生—护理学]