外伤性颅骨缺损修补手术80例临床经验总结

目的探讨外伤性颅骨缺损修补手术的适应证、时机、材料选择、技巧及并发症的防治。方法对80例外伤性颅骨缺损行颅骨修补手术患者的临床资料进行回顾性分析。结果外伤性颅骨缺损分别选用进口钛板46例。自体骨15例，硅橡胶涤纶丝网12例，有机玻璃6例，同种异体骨1例。颅骨修补手术距受伤时间45d-6年。手术方法有覆盖法和镶嵌法。18例出现不同程度的术后血肿、积液、感染、癫痢等并发症，发生率22．5％，无手术死亡病例。结论对于颅骨缺损直径≥3cm、颅骨缺损时间2—3月为最佳手术时机。目前手术材料选用进口钛板，其手术方法最简单，并发症最少，疗效最佳。

Clinical experiences of cranioplasty for traumatic skull defect in 80 cases

Objective To explore the indication,operative time,materials selection,surgical skills and prevention of complications in the treatment of traumatic skull defect.Methods Clinical data of 80 cases of traumatic skull defect treated with cranioplasty were retrospectively analyzed.Results Traumatic skull defects were reconstructed by overlay technique or inlay technique with the imported titanium alloy mesh in 46 cases,autologous bone in 15 cases,silicone mesh in 12 cases,methacrylate in 6 cases and homologous bone in 1 case.The operation time after injury ranged from 45 days to 6 years.18 cases presented with complications as hematoma,subcutaneous effusion,infection and epilepsy,with the incidence of 22.5% but with no operative death.Conclusion The best operative time maybe 2 to 3 months after injury in patients with at least 3 cm of skull defect in diameter.The imported titanium alloy mesh is the best material in cranioplasty for its simplicity,less complication,and excellent effect.