颅骨缺损的临床分型与治疗模式探讨

Clinical typing and treatment of skull defects

目的 :探索颅骨缺损的适宜修补时机与新型手术方法。方法 :5 10例颅骨缺损病人根据不同病因分为减压型和非减压型两种类型 ;再依据骨窗区新生骨形成与否分为新生骨形成型和无新生骨型两种。以钛网片为修补材料 ,分别于开颅同期、术后 2个月和 5～ 6个月 ,选择颅骨钻孔固定 (Ⅰ组 )和钛网 骨膜缝扎法 (Ⅱ组 )修补颅骨缺损。结果 :全部病例手术效果优良率均为 10 0 % ,但Ⅰ组术后并发症 (4.86 % )明显高于Ⅱ组 (0 .71% ) ,P <0 .0 5。结论 :根据颅骨缺损分型选择适宜时机手术修补颅骨缺损 ,有利于神经功能早期恢复 ;钛网 骨膜缝扎法可降低术后并发症。

Objective:To investigate suitable opportunity and method of cranioplasty.Methods:According to the cause of disease and the condition of neoformative bone,510 patients with skull defects were diveded into 4 types:decompression type,non-decompression type,neoformative bone type and non-neoformative bone type.Regarding titanium-nut as repair material,sphenotresia (group one) or sutrue of pericranium to titanium-nut(group two) was selected to repair skull defects at the same time of craniotomy,two months or 5-6 months later post-operation respectively.Results:All patients had a good curative effect,but the incidence of post-operative complication in group one was higher than that of group two( P <0.05).Conclusion:It might be beneficial to accelerate the recovery of nervous system function by cranioplasty at the suitable opportunity according to the type of skull defect.Suture of pericranium to titanium-nut can decrease the incidence of post-operative complication.