自体颅骨粉一期修复颅骨缺损的临床应用

目的探讨用自体颅骨骨粉一期修复颅骨缺损的临床应用. 方法 1999年10月～2002年12月,采用自体颅骨骨粉加医用黏合剂原位黏合,对128例重型颅脑损伤、急性颅内血肿、颅骨肿瘤及脑肿瘤并颅骨侵犯开颅术后行一期再植成形术,术后随访3～24个月,通过CT或X线片观察骨质生长情况. 结果一次完成减压及成形术,时间较常规手术延长5～l0分钟,修复颅骨外观正常,无凹陷、突出,术后12个月再植骨与正常颅骨完全融合,类似正常颅骨形态.再植修复成功123例,占96.1%,5例因骨粉量少成形欠佳,但未见脑搏动和缺损综合征,均不需二期修补. 结论自体颅骨骨粉加医用黏合剂一期颅骨再植成形术,能够有效避免传统的二期颅骨缺损修补术和并发症.

CLINICAL OBSERVATION OF ONE STAGE CRANIOPLASTY FOR SKULL DEFECT WITH SELF-CRANIAL BONE POWDER

Objective To investigate the clinical application of self-cranial bone powder in one stage cranioplasty. Methods From October 1999 to December 2002,self-cranial bone powder and medical adhesive were used to repair the skull defect, for one stage cranioplasty, caused by operations on cranium in 128 cases of severe dangerous craniocerebral injury, acute intracranial hematome, sick skull and intracranial tumor.The bone growth was observed by CT or X-ray examination 3-24 months after replantation of cranioplasty. Results The decompression and cranioplasty were performed simultaneously, the time prolonged 5-10 minutes than that of routine, the appearance of repaired cranial bone was normal, without concavity and convexity. After 12 months of operation, the replanted bone merged with the normal bone completely, with normal appearance. The operation successful rate was 96.1%(123125) without any complication. Only five cases were not better in growing because of less bone powder, but without cerebral pulse and defective syndrome. All the cases did not need secondary cranioplasty. Conclusion The effect of cranioplasty with self- cranial bone powder effect is good in taking shape. This new method can avoid the traditional secondary cranioplasty for skull defect and complications.