自体骨移植修补颅骨缺损的材料与方法

目的：探讨自体游离骨及组织工程技术在颅骨缺损修补中的应用。资料来源：应用计算机检索Pubmed1985—01／2006—02和proQuest1995—01／2006—02期间的相关文章，检索词“cranial bone graft，autologous bone flap，calvarial bone graft,autogenous bone graft，autograft，autotransplant，bone autograft，tissue—engineered bone repair，autologous bone，craniotomy defect repair．cranioplasty。”限定语言种类为English。资料选择：筛除以上资料中非颅骨缺损的、非自体骨移植的、非自体骨组织修复的研究，剩余结果通过手工及光盘检索全文。资料提炼：共检索到88篇文献，内容涉及颅骨成型术、颅骨缺损、自体游离骨瓣、颅骨重建．颅骨修补、骨移植材料、组织工程等。删除重复文献55篇，纳入33篇。资料综合：修补材料与方法的选择是颅骨缺损修补手术成败的关键。自体骨移植材料修补颅骨缺损已在临床广泛应用，并随着组织工程技术与基因工程技术的发展．使颅骨骨移植向一体化骨整复方向发展。自体骨移植材料的应用进展：①常用自体游离骨瓣：包括胫骨、颅盖骨、肋软骨和肋骨．肩胛骨和胸骨和髂骨。②自体骨移植材料的选择：自体颅骨瓣为首选的修补材料．必要时可联合应用肋骨．髂骨修补缺损。③组织工程技术在颅骨修补术中的应用：大体可分为3个步骤：采集供体组织和分离成骨细胞；利用CT扫描资料构建基于图像分析设计组织工程支架：在预制的聚合体支架上种植细胞并移植于缺损区。结论：自体骨移植因无免疫反应．易于与受区骨整合．是颅骨重建的优先选择材料之一：组织工程技术在颅骨修补中的应用，有待于进一步深入研究。

Material and method in the reconstruction of cranial bone defect with autograft bone

OBJECTIVE： To investigate the applications of autografl free bone and tissue-engineered technology in reconstruction of cranial bone defect.
DATA SOURCES： A computed-based search was conducted to query the literatures published in Pubmed from January 1985 to February 2006 and ProQuest from January 1995 to February 2006, using query words of ＂cranial bone graft, autologous bone flap, calvarial bone graft, autogenous bone graft, autograft, autotransplant, bone autograft, tissue-engineered bone repair, autologous bone. craniotomy defect repair, cranioplasty＂, and language was limited to English.
STUDY SELECTION： The data unrelated to the study of cranial bone defect, autologous bone graft or reconstruction with autologous bone tissue were deleted, and the full texts of the left articles were searcbed by manual and disc query.
DATA EXTRACTION： Totally 88 articles were selected, concerning cranioplasty, cranial bone defect, autologous free bone flap, cranial bone reconstruction, cranial bone repairing, bone-graft materials, tissue engineering and so on. And 55 repeated articles were excluded while other 33 ones were included at last.
DATA SYNTHESIS： The choice of materials and methods is the key of the reconstruction of cranial bone defect. The reconstruction of cranial bone defect with bone autograft materials has been widely used in clinical practice. With the development of tissue-engineered or gene-engineered technology, the transplantation of auto-cranial bone will develop into integrated bone reconstruction. The application progress of bone autograft materials is summarized in several aspects as following： （1） Common autologous free bone flap： tibia, calvarial bone, rib cartilage and rib, scapula, breast bone and iliae bone; （2） The choice of bone autograft materials： Autologous free bone-flap is the first choice of repairing materials, and may be associated with rib or iliac bone at the same time when necessary, （3）The application of tissue-engineered technology for the r