开放性颅骨缺损急诊术中一次完成自体修复的临床研究

A clinical study on autogenous repairing of open skull fracture during emergency operation

目的 研究并客观评价开放性颅骨缺损急诊术中一次完成自体修复的可行性。方法 对１７例 开放性颅骨骨折病例（伤后２４小时内）常规清创处理，同时将创伤区粉碎之颅骨用骨钳咬碎成３～５ｍｍ颗 粒，与制备好的脱钙人牙基质２～６ｇ均匀混合，平铺在颅骨缺损区的硬脑膜上，覆盖头皮，分层缝合。结果 全部病例骨缺损区于术后１个月逐渐骨化，触之变硬，与周围骨窗融合良好。Ｘ线片见骨窗区骨碎粒逐渐融 合，缺损区普遍密度增高。结论 对开放性颅骨缺损在急诊清创的同时，使用脱钙人牙基质诱导缺损颅骨 自体修复是对传统治疗方法的一种突破。

Objective To research and evaluate the possibility of autogenous repairing. Methods Seventeen cases of open skull fracture were selected(8 cases of 3-4cm defective area,6 cases of 5-6cm and 3 cases of 7-8cm), under only one routine debriedement all cases were used with DHDM 2-6g according to the range of defective area and mixed with smashed bone pieces grinding into 3-5mm in diameter, scattered it on the dure mater surface then skin flap was overlapped and sutured in layers. Results All cases of defective area had gradual osteogensis after 1 month, rigidness of touching on the surface, the bone window margin and defective area were fused very well. X-ray film showed the bone pieces of bone window were fused gradually,the density of defective area increased generally. Conclusion This study demonstrates that DHDM can induce autogenous repairing of skull defect during the debriedement was performed. It is a break throw of traditional therapeutic method. The curative effect is reliable.