颅骨修补材料的选择及其评价

Selection and evaluation of materials for skull repairing

背景:对颅骨修复材料的分类、性质及其在颅骨修补和塑形中的应用和相关并发症的处理进行归纳总结。方法:第一作者应用计算机检索PubMed数据库(http://www.ncbi.nlm.nih.gov/PubMed),检索关键词"codubix,synmesh,bone cement",限定语言种类为"English";同时检索CNKI数据库(www.cnki.net/index.htm),检索关键词"颅骨修补材料,钛网,骨水泥",限定语言种类为中文。选择文章内容与颅骨修补材料种类、材料学特性、组织相容性及其应用效果相关,同一领域文献则选择近期发表或发表在权威杂志文章。排除重复及较陈旧的文献。共纳入26篇文献。结果:骨水泥组织相容性好但不易被吸收,只应用于部分颅骨的修补。经过对比发现钛因其良好的生物相容性可与颅骨结合,使其应用得到了进一步研究,具备较好的应用前景,但也存在很多不足之处。随着生物工程研究的不断深入,骨组织工程、软骨组织工程等研究的深入将会为颅骨修补材料的开拓提供更广阔的前景。结论:颅骨缺损修补材料有很多种,文内只介绍了其中应用较广泛的一些,结合临床实际工作,修补材料选择时要结合患者的病情、经济条件、当地的设备及技术水平等。若经济条件允许情况下,应首选纯钛网及钛钉,因术中塑形方便,不需处理骨窗缘即可固定,且并发症极少,不影响术后X射线检查,手感良好,均匀美观。自体骨及骨水泥应用时,应注意减少相应的并发症,及时有效的处理,也会获得良好的效果。

OBJECTIVE：To summarize the classification,property of skull repair material and the processing of related complications in the application of repairing and remodeling the skull.METHODS：The PubMed database（http：//www.ncbi.nlm.nih.gov/PubMed）and CNKI Database（www.cnki.net/index.htm）was searched by the first author using key words of＂codubix,synmesh,and bone cement＂both in English and Chinese.Articles whose content is related to the types,property,biocompatibility and its application effect of skull repairing materials were selected.In the same field,the articles published by authoritative journals or different races were preferred.The repetitive or obsolete literatures were excluded.After that 26 documents were included in this paper.RESULTS：The bone cement exhibited good histocompatibility,however,it is difficult to be absorbed,thus,it only be used for repairing part of skull defects.The study found that titanium had good biocompatibility and could combine with the skull.Its application had a promising prospect,but there are many inadequacies.With the continuous deepening of bio-engineering,bone tissue engineering,and cartilage tissue engineering,it will provide a broader perspective for the study of skull repair materials.CONCLUSION：There are many kinds of materials for skull repairing,and this paper only introduces some of the widely used ones.Actually,the selection of repairing materials should consider the pathogenetic condition,economic condition,local equipment and technical levels.If possible,titanium mesh and titanium screw are preferred,which is characterized by easy operation,few complication and beautiful appearance.When using autogenous bone or bone cements,if related complications can be reduced and handled effectively,the results will be satisfactory.