三维EH复合型人工颅骨板修补颅骨缺损53例

目的:观察三维EH复合型人工颅骨板在修补颅骨缺损中的作用.方法:回顾性分析2004-07/2007-05泰兴市人民医院神经外科住院患者53例,男31例,女22例;年龄19～68岁,均符合颅骨修补适应证.颅骨缺损原因:创伤41例,高血压7例,肿瘤3例,动脉瘤2例.13例患者为双侧颅骨缺损.额部颅骨缺损5片(其中合并眶部严重缺损2例),颢部9片,额颞部42片,颞顶部3片,项枕部4片,额顶部3片.单片最小缺损面积为4 cm×6 cm,最大缺损面积12 cm×18 cm.全部患者均采用经螺旋CT(层厚≤5 mm)扫描、CAD三维重建成像、快速成型技术顶制的三维EH复合型人工颅骨板进行颅骨修补.观察有无切口感染、排异反应及并发症发生.结果:53例患者均获得随访,平均随访18个月.患者对塑形的满意率达100%.其中2例患者曾分别于术后4 d和1周时出现轻度皮瓣下积液,经穿刺抽吸加压包扎同时应用抗生素预防感染处理后积液于短时间内消失.未见其他颅骨修补术后常见的并发症.结论:三维EH型复合人工颅骨板具有良好的生物相容性,操作方便,外形满意,并发症少,是一种理想的颅骨修补材料.

Three-dimensional EH composite artificial template for repairing cranial defect in 53 cases

OBJECTIVE: To observe effects of three-dimensional EH composite template on repairing cranial bone defect. METHODS: A total of 53 inpatients were analyzed retrospectively at the Department of Neurosurgery, Taixing People's Hospital from July 2004 to May 2007, comprising 31 males and 22 females, aged 19-68 years. They were in accordance with cranial repairing indication. Reasons for skull defect: traumatic brain injury (41 cases), hypertension (7 cases), intracranial cancer (3 cases), intracranial aneurysm (2 cases). Thirteen patients developed bilateral cranial defect. The defect region: frontal (5 slices, comprising 2 with severe orbital part defect), temporal (9 slices), frontotemporal (42 slices), temporoparietal (3 slices), parietoocipital (4 slices), frontoparietal (3 slices). The smallest single-chip defect size was 4 cm × 6 cm, and the largest one was 12 cm×18 cm. All the patients were mended by three-dimensional EH composite template using spiral CT (≤5 mm thickness) scanning, CAD three dimensional reconstruction, quickly modeling technique. Infection of incisional wound, rejection and complications were observed. RESULTS: A total of 53 patients were followed up, with an average follow-up period of 18 months, and all of them were satisfied with the shapes (100%). Mild collection of the fluid under the scalp was found in 2 cases 4 days and 1 week following surgery, and disappeared after suction and pressure dressing. No other frequent complications were observed after cranioplasty. CONCLUSION: Three-dimensional EH composite template is an ideal material for cranial bone defect, because of its good biocompatibility, easy operation, good postoperative shape and less complications.