三维塑形钛网与超低温保存自体颅骨在早期颅骨修补中的临床效果观察

The clinical effect of three-dimension shaping titanium mesh and ultra-low temperature preservation of autologous skull in early skull repair

目的探讨三维塑形钛网与超低温保存自体颅骨在去骨瓣减压术后早期行颅骨修补中的临床疗效及并发症的差异。方法回顾性分析我院2013年3月至2018年3月我院收治的去骨瓣减压术后行颅骨修补患者155例,根据颅骨修补材料不同分为自体颅骨组和三维钛网组。两组患者均早期行颅骨修补,自体颅骨组与三维钛网组分别采用超低温保存自体颅骨和三维塑形钛网作为修补材料,比较两组患者术后并发症发生率和临床疗效。结果两组患者颅骨修补术后各项并发症差异无统计学意义(P>0.05),但总体并发症发生率比较差异有统计学意义(P<0.05)。两组患者颅骨修补后头颅外观缺陷差异无统计学意义(P>0.05),在头皮不适及自觉头部畏冷热方面差异有统计学意义(P<0.05),且自体颅骨组患者满意度高于三维钛网组(P<0.05)。两组患者颅骨修补术前及术后Karnofsky功能评分(KPS)差异无统计学意义(P>0.05)。结论颅脑损伤去骨瓣减压术后早期行颅骨修补时,使用超低温保存自体颅骨较三维塑形钛网的总体并发症低,且患者术后满意度高,值得推荐。

Objective To compare the differences in clinical effect and complications between three-dimension shaping titanium mesh and ultra-low temperature preservation of autologous skull in early cranioplasty after decompression.Mehhods A retrospective analysis was performed on 155 patients admitted to our hospital from March 2013 to March 2018 and undergone skull repair after decompressive craniectomy.The patients were divided into autologous skull group and titanium mesh group according to the different skull repair materials.The patients in both groups received cranial repair in the early stage after decompression with bone flap removal.The autologous skull group used autologous skull as repair materials and the titanium mesh group used three-dimension shaping titanium mesh as repair materials.The incidence of postoperative complications and clinical efficacy were compared between the two groups.Results There was no statistically significant difference in the various complications after cranioplasty(P>0.05),but there was a statistically significant difference in the overall complications(P<0.05).There was no statistically significant difference in the appearance defect of the skull after cranioplasty between the two groups(P>0.05),but there was statistically significant differences in scalp discomfort and head fear of cold and heat(P<0.05).The satisfaction of the patients in the autologous skull group was higher than that in the titanium mesh group(P<0.05).There was no statistically significant difference in KPS scores between the two groups before and after cranioplasty(P>0.05).Conclusion In early cranioplasty after craniotomy and decompression of craniocerebral injury,ultra-low temperature preservation of autologous skull has lower overall complications and the postoperative satisfaction of patients is high.It is worthy of recommendation.