几种颅骨修补材料的临床应用及并发症防治

背景：近年来颅骨修补材料也在不断更新,主要有自体材料、同种异体材料和异体材料。目的：总结近年来常用的颅骨修补材料的临床应用及并发症的防治。方法：由作者应用计算机检索维普数据库中与颅骨修补材料及并发症有关的文章,检索时限2002-01/2010-10。检索关键词：颅骨修补;修补材料;自体骨;硅胶;骨水泥;EH复合材料;钛网;并发症。纳入标准：与颅骨修补材料及并发症有关的文章。排除标准：重复研究或较陈旧文献。根据纳入排除标准共保留相关文献45篇。结果与结论：自体骨组织相容性好,无排异现象,但来源受到限制,移植物可被吸收。医用硅胶价格低廉,但组织相容性不够;骨水泥取材容易,价格便宜,但易损伤脑组织。EH复合材料组织相容性和骨结合性较好,但病例数不够。钛合金组织相容性好、性质稳定,但价格昂贵。应根据患者病情、经济条件、当地设备及技术水平等选择理想的颅骨修补材料,努力避免或减少并发症的发生。

Clinical application of various skull repair materials and the prevention and cure of complications

BACKGROUND： In recent year, there are many new materials for skull repair, including autologus substitute, allograft materials and allogenic materials. OBJECTIVE： To summarize clinical application of commonly used skull repair materials in recent years and the prevention and cure of complications METHODS： Papers regarding skull repair materials and complications published in VIP data between January 2002 and October 2010 were researched using key words of ＂cranioplasty; repair materials; autologous bone; silica gel; bone cement; EH composite; titanium mesh and complication＂. Inclusion criteria： papers regarding skull repair materials and complications. Exclusion criteria： repetitive study and relatively old literature. A total of 48 documents were included in this study. RESULTS AND CONCLUSION： Autologous bone has better histocompatibility, no rejection phenomenon, but the source is limited and graft can be absorbed; Medical silicone is cheaper, but histocompatibility is not enough; Bore cement derived easily and cheaper, but easy to damage the brain tissue; EH composite materials has better histocompatibility and synostosis, but number of cases is not enough; Titanium mesh has better histocompatibility, more stable, but is more expensive. We should select the ideal cranioplasty material based on patient＇s condition, economic conditions, the level of local equipment and technology, and try to avoid or reduce complications.