自体颅骨修补术治疗颅骨缺损

Autogenous bone flop to perform cranioplasty

目的探讨冷冻保存的自体颅骨在颅骨缺损修补术中的应用价值。方法将150例患者去骨瓣减压获得的颅骨密封于双层无菌塑料袋,保存于-17℃冰箱。术后1～3月,患者适合做颅骨成形术时,取出冻存的颅骨,在常温解冻后复位固定于原骨窗。术后定期随访,观察头颅外观,并利用CT扫描观察骨瓣缘的吸收情况。结果147例患者达到一期愈合;2例患者因抓抠伤口骨瓣暴露发生感染,经换药引流无效,进行了二次手术取出骨瓣。20例出现皮下积液,均行穿刺加压包扎,伤口一期愈合。1例患者术后一年出现溶骨、骨瓣断裂现象,再次手术取出骨片,钛网修补。结论冷冻保存的自体颅骨可以安全、可靠地用于颅骨修补,外观上更接近解剖学特点,更能接近患者容貌,患者无心理障碍,且费用低廉,患者更易于接受,值得推广。

Objective To investigate the application of frozen autogenous bone flap to delayed cranioplasty in the patients with cranioeerebral injury. Methods The bone flaps obtained from initial deeompressive craniotomy in the patients with craniocerebral injuries were preserved at -17℃ after being sealed in 2 layers sterile vinyl bags of. After a certain period ranging from 1 month to 3 months,the cranioplasty was performed in 150 patients with cranial bone defects induced by the eraniocerebral injuries. The patients were examined by CT during the following up. Results 147 cases healed; 2 patients wrdcrment to due to wound infection, wrdcrment to the 20 cases emerge subcutaneous fluid collection, healed after performed puncture evacnation and pressure bandage. One case appeared osteolysis and bone fracture in one year the, bone chip was replacld by titanium mesh patch, in second operatin Conclusion Cryopreservation of autologous skull can be safely and reliably used in cranioplasty. The appearance is closer to anatomical features and better looks. The patient have no psychological barriers. It is low-cost, more acceptable to patients,and worthy of promoting.