钛网Ⅰ期修补开放性、粉碎性颅骨骨折:远期随访验证可行性

Primary reconstruction with titanium mesh in comminuted and open skull fracture:long-term follow-up to verify its feasibility

背景:目前国内外学者普遍认为钛网理化性优良,易塑形,易裁剪,耐腐蚀性及耐磨损性好,无磁性,对CT或MRI结果影响较小,而且具有良好的抗压性,组织相容性好,是较理想的颅骨修补材料。目的:探讨钛网Ⅰ期修补在开放性、粉碎性颅骨骨折中应用的可行性。方法:回顾性分析62例开放性、粉碎性颅骨骨折患者的临床资料,男49例,女13例,年龄7-69岁,其中30例Ⅰ期仅行清创,术后6-12个月再行钛网颅骨修补,作为对照组;另32例清创的同时Ⅰ期行钛网颅骨修补,作为观察组。随访1至2年,观察两组切口愈合、并发症及住院费用。结果与结论:随访1至2年,62例患者均未发生切口感染与颅内感染;对照组术后颅内血肿、癫痫发生率及其他并发症发生率均高于观察组(P<0.05),住院费用高于观察组(P<0.05)。结果表明在掌握严格适应证的开放性、粉碎性颅骨骨折中,钛网Ⅰ期修补是完全可行的,能明显减少并发症的发生,降低住院费用。

BACKGROUND：At present, scholars general y believe that the physical and chemical properties of titanium mesh are fine as easy plastic, easy cutting, good corrosion resistance and wear resistance, non-magnetic, less effect on CT or MRI results, good histocompatibility and resistance to stress. The titanium mesh is regarded as an ideal material for cranioplasty. OBJECTIVE：To explore the clinical feasibility of primary reconstruction of comminuted and open skul fracture with titanium mesh. METHODS：Sixty-two cases of comminuted and open skul fracture were analyzed retrospectively, including 49 males and 13 females, aged 7-69 years. Among these 62 patients, 30 patients underwent debridement and then after 6-12 months, they received titanium mesh reconstruction, serving as control group. Another 32 cases underwent debridement and titanium mesh reconstruction in the same time as observation group. Al the cases were fol owed-up for 1-2 years to observe wound healing, complications and hospitalization cost. RESULTS AND CONCLUSION：During the fol ow-up, no wound infection and intracranial infection occurred in the two groups. The incidence of intracranial hematoma, epilepsy, and other complications was higher in the control group than the observation group （P〈0.05）, and the hospitalization cost was also higher in the control group than the observation group （P〈0.05）. These findings indicate that primary reconstruction with titanium mesh is feasible in the treatment of comminuted and open skul fracture and can significantly reduce the incidence of complications and hospitalization costs.