颅骨缺损 [数字化成形二维钛网在颅骨缺损修补中的应用研究]

　　[摘要] 目的 研究数字化成形二维钛网修补颅骨缺损的应用价值。 方法 将纳入研究的病例46例随机分为两组，治疗组26例行数字化成形二维钛网颅骨缺损修补术；对照组20例行传统手工塑形三维钛网颅骨缺损修补术。比较两组患者手术时间、术中出血量、术中钛网塑型安装时间、钛钉使用数量、术后并发症和患者对修复后容貌满意度。 结果 与对照组比较，治疗组手术时间、术中出血量、术中钛网塑型安装时间、钛钉使用数量、术后并发症发生率均明显少于对照组，差异有统计学意义（P < 0.05）。治疗组修复后容貌满意度明显高于对照组（P < 0.05）。 结论 采用数字化成形二维钛网进行颅骨修补术手术操作相对简便，手术时间短，出血量、钛钉使用量及手术并发症少，较完美地恢复了患者颅骨外形，并且硬度高，起到较好保护作用。
　　[关键词] 数字化成型；钛网；颅骨缺损；颅骨缺损修补
　　[中图分类号] R651.15 [文献标识码] A [文章编号] 1673-7210（2012）08（b）-0028-03
　　Application study of digitally formed two-dimensional titanium mesh in skull defect repair
　　NING Jinlong HUANG Jianfeng▲ YI Chunjun ZHONG Xiangqiu CEN Dingshan LUO Zhiming ZHI Hanxing HE Muliang LI Honglin
　　Department of Neurosurgery, Hospital of TCM in Hezhou City, Guangxi Zhuang Autonomous Region, Hezhou 542800, China
　　[Abstract] Objective To study the application value of digitally formed two-dimensional titanium mesh in skull defect repair. Methods 46 cases of patients were randomly divided into two groups. 26 cases in the treatment group were performed digitally formed two-dimensional titanium mesh skull defect repair; 20 cases in the control group were performed traditional manually reconstructed three-dimensional titanium mesh skull defect repair. The surgery time, intraoperative blood loss, titanium mesh reconstruction time, number of titanium nail used, postoperative complications and patients" satisfaction with their repaired appearance were compared between the two groups. Results Compared with the control group, the surgery time, intraoperative blood loss, titanium mesh reconstruction time, number of titanium nails used and incidence of postoperative complications in the treatment group were significantly shorter or less (P < 0．05); patients" satisfaction with their repaired appearance in the treatment group was significantly higher than that in the control group (P < 0．05). Conclusion The use of digitally formed two-dimensional titanium mesh in skull defect repair is more convenient, which has shorter surgery time, less intraoperative blood loss, number of titanium nails and postoperative complications. Digitally formed two-dimensional titanium mesh can more satisfactorily repair the skull appearance. Its high hardness can ensure better protective effect.
　　[Key words] Digital molding; Titanium mesh; Skull defect; Skull defect repair
　　颅骨缺损是神经外科临床工作中常见的术后遗留问题，患者对颅骨修补后头颅形状的满意程度直接影响其今后社交生活的心态，对患者今后的生活产生较大的影响。本研究将我院2007年3月～2011年10月收治的颅骨缺损病例46例随机分为两组，治疗组26例行数字化成形二维钛网颅骨缺损修补术，对照组20例行传统手工塑形三维钛网颅骨缺损修补术，将两组疗效进行比较分析，现总结报道如下：