不同颅内植入材料对脑损伤修复的影响

Effect of different intracranial implant materials on brain injury repair

背景:有关脑损伤修复移植物选择尚有争议,迄今还没有一种材料能在理化性质方面完全替代颅骨。目的:归纳分析不同颅内植入材料对脑损伤修复的影响及其性能评价。方法:以"颅脑损伤、复合材料、生物材料、损伤修复"为中文关键词,以"Traumatic brain injury,Compound material,Biological material,Damage repair"为英文关键词,采用计算机检索中国期刊全文数据库、PubMed数据库(1993-01/2010-11)相关文章。纳入颅脑损伤-损伤修复材料等相关的文章,排除重复研究或Meta分析类文章。结果与结论:共入选24篇文章进入结果分析。常用的颅骨缺损的修补材料主要有3大类:自体和异体骨移植、非金属材料、金属代材料。自体和异体骨移植成形不很理想,存在免疫排斥和坏死吸收。以钛网边作为修复材料,应用三维重建技术的数字化颅骨塑形技术,缩短了手术时间、减少了相应并发症,实现了个体化配置修补颅骨缺损,是一种较为理想的颅骨修补材料。钛合金具有良好的生物相容性,强度高,不老化,密度轻,置入后不影响CT/MRI、脑电图等检查,且置入后成纤维细胞可长入钛网的微孔,使钛网与组织融为一体,明显减少并发症的产生,是目前较为理想的修补材料。

BACKGROUND： Choice of graft materials for brain injury repair is still controversial, and so far no single material can completely replace the skull in the physical and chemical nature. OBJECTIVE： To conclude the effect and properties evaluation of different intracranial implant materials on brain injury repair. METHODS： A computer based search of CNKI and PubMed （1993-01/2010-11） was performed for relevant articles. The Keywords were ＂traumatic brain injury, compound material, biological material, damage repair＂ in Chinese and English, respectively. Repetitive articles and Meta analysis were excluded. RESULTS AND CONCLUSION： Finally, 24 articles were included in result analysis. There are three kinds of repair materials for skull defects： autologous and allogeneic bone graft, non-metallic materials, metal-generation materials. Autologous and allogeneic bone graft is not good at shaping, and there is absorption of immune rejection and necrosis. Titanium mesh materials as an ideal material for cranioplasty can shorten surgical time and reduce the corresponding complications by using three-dimensional digital skull shaping technology, which realize individual configurations to achieve the repair of skull defects. Titanium alloy has good biocompatibility, high strength, not aging, low density, no influence on CT/MRI, electroencephalogram and other tests; after titanium alloy implantation, fibroblasts may grow into the porous titanium mesh to realize the integration of titanium mesh with surrounding tissues, which significantly reduces the complications.