颅颌骨及眶缺损治疗临床研究

CLINICAL RESEARCH ON THE TREATMENT OF DEFECTS OF CRANIO-FACIAL AND ORBIT BONES

目的：为了探讨颅颌骨及眶缺损的修复方法，观察各种修复体植入后的变化方法：从1990年将收治的各种颅颌骨及眶骨损的52例病人分为两组，分别采用自体骨移植和组织代用品治疗，术后随访3～5年，通过头颅CT及X光定位片投影测量，了解植入物的变化、吸收程度和固定装置的情况：结果。自体骨移植尤其是带血管蒂的骨移植，愈合快，吸收少，仍是最佳的治疗方法。游离骨移植效果比较稳定，吸收较大，达25％～35％。组织代用品Medpor、Gore－Tex相容性好，治疗效果稳定，硅橡胶、羟基磷灰石及记忆合金均有发生组织反应而取出的病例。

Clinical cases with defects of craniofacial and orbit bones were followed after transplantation of tissue subtitutes to compare the results of different reconstructive methods. Methods: Two small groups of 52 cases sufferingfrom defects of craniofacial bones, received transplantative of autobone grafts and tissue substitutes respectly,were followed up as long as 3～5 years. The changes, absorption and fixation of implants were investigatedthrough computer tomography and standard skull roentgenograms. Conclusion: Transplantation of bone grafts,especially the vascularized bones is considered the best way with rapider healing and less absorption. The estimative absorption rate of free bone grafts was ranged from 25 % to 35 % with less tissue responds. Medpor and GoreTex PTFE are good selections of tissue substitutes with stable results and good histocompatibility. But in severalcases, tissue substitutes, including silicone, oxhydrylphosphorite and memonic alloy have to be taken out throughoperations due to strong responds.