去骨瓣减压预置防黏连膜配合颅骨三维预制体在颅骨修补术中的运用

Application of preset adhesion-prevention membrane in decompressive craniectomy combined with skull three dimensional perform in cranioplasty

目的探讨去骨瓣减压预置防黏连膜配合颅骨三维(3D)预制体在颅骨修补术中的临床应用价值。方法将80例单侧预行大骨瓣术患者分为研究组和对照组两组,每组各40例。研究组预置防黏连膜,对照组未置。颅骨缺损部位应用计算机3D重建EH(医用树脂和羟基磷灰石复合人工骨材料)复合型颅骨预制体进行修补。分别对两组患者出血量、手术时间及应用CT对两组颅骨修复后的头颅外观形态以自身健侧数据作镜像对比进行统计学分析。结果研究组出血少,手术时间短,头颅外观对称、整容效果佳,差异均有统计学意义(P<0.05或P<0.01)。结论此新法修补缺损颅骨,能使患者恢复原有外形,达到完美的整容效果;降低患者术中手术风险;为临床医生寻求简便、迅速、安全的颅骨修复方法提供依据。

Objective To explore the clinical application value of preset adhesion-prevention membrane in decompressive craniectomy combined with skull three dimensional(3D) perform in cranioplasty.Methods Eighty patients with unilateral pre-conducted large bone flap operation were divided into two groups,the study group(n=40) and the control group(n=40).The adhesion-prevention membrane was preset in the study group but not in the control group.For defect sites of skull,skull repair was carried out by means of computerized 3D reconstruction EH(medical resin and hydroxyapatite artificial bone composite material) of composite skull perform.Statistical analyses were respectively carried out for bleeding amount,operation time and cranial morphology of skull repair by CT with own healthy-side data as image contrast.Results The bleeding amount was less,operation time was shorter,skull appearance was symmetry and cosmetic effect was good in the study group.The differences were statistically significant(P<0.05 or P<0.01).Conclusion This new method used for repairing defect skulls could enable patients to restore their original appearances to achieve the perfect cosmetic effect,reduce intra-operative risk and provide a basis for clinician to seek a convenient,rapid and safe skull repair method.