脱钙人牙基质诱导创伤性颅骨缺损急性期一次性修复的临床应用研究

目的 :探索一种创伤性颅骨缺损急性期术中一次性修复的新方法。方法 :采用弃用人牙提取脱钙人牙基质 ,利用其中的骨形态发生蛋白 (bonemorphogeneticprotein ,BMP) ,在动物实验诱导骨再生修复成功后 ,对 2 2例创伤性颅骨缺损在急性期进行术中一次性修复。病人年龄 8～ 6 4岁 ,颅骨缺损范围 4～ 5cm 14例 ,6～ 8cm 8例 ;开放伤 17例 ,闭合伤 5例。颅骨缺损区用脱钙人牙基质 2～ 6g ,与颅骨碎粒及骨屑均匀混合平敷在硬膜外颅骨缺损区内 ,术后临床检查、X线评价 ,CT多点骨密度值测定。结果 :术后第 3周修补区能耐受压力 ,X光片见骨窗区骨碎粒逐渐融合 ,CT值由最初 2 0～ 40Hu上升 2 0 0～ 70 0Hu ,一年后 >90 0Hu。全部病例无感染发生 ,未显免疫排斥反应。结论 :从弃用人牙提取人的BMP ,用此材料对创伤性颅骨缺损急性期术中一次性修复 ,简单、有效。变二次手术一次完成 ,有别于传统的颅骨修复方法 ,具良好的应用前景。

A clinical study on primary repair of traumatic skull defect with decalcified humen dental martix in acute period

Searching for a new method for repair of traumatic skull defect.Methods:Decalcified humen dental martix was made from dentary out of use.Bone morphogenetic protein was used on patients.After animal model were made successfully,22 patients with traumatic defect of cranial bone were primarily repaired. The cranial defects were repaired with mixed material of 2-6g decalcified humen dental martix and fraction of cranial bone.Results:The mixed material hardened after 3 weeks.Initial measurement of CT scaning was 20-40Hu,after that,raised 200-700Hu,and>900Hu after 1 year.Conclusion:The humen BMP was made from dentary out of use.Primary repair of cranial defect was performed in traumatic head injury with the kind of material in acute period. The method was different from those habitual practice,and had better application.