数字化成形三维钛网颞肌外修补术在颅骨缺损治疗中的应用

Application of digital three-dimensional titanium mesh repair in the treatment of skull defect

目的探讨数字化成形三维钛网颞肌外修补术在颅骨缺损治疗中的临床应用价值.方法选择2012年4 月-2015年4月收治并进行数字化成形钛网颞肌外修补颅骨缺损术的38例患者,与2007年7月-2012年3月采用颞肌下修补颅骨缺损术的36例患者的临床资料进行比较.结果颞肌外组病人手术时间、术中出血量、总引流量、留置引流管天数均少于颞肌下组（P〈0.001）,皮下积液发生率低于颞肌下组（P〈0.05）,术后外观满意度高于颞肌下组（P〈0.01）,局部疼痛发生率、颅骨缺损综合征好转率两组比较无统计学意义（P〉0.05）.结论数字化成形钛网颞肌外修补颅骨缺损术手术时间短,创伤小,术中、术后出血少,对颞肌损伤、脑组织干扰小,外观满意,总体效果优于颞肌下修补术.

Objective To explore the clinical value of digital three-dimensional titanium mesh repair in the treatment of skull defect. Methods 38 cases of skull defect admitted to hospital and underwent digital three-dimensional titanium mesh repair from April,2012 to April,2015 were selected to this study.And their clinical data were compared to clinical data of 36 cases w,ho underwent repair of skull defect under temporal muscle from July,2007 to March,2012.Results Operation time, bleeding volume,total drainage volume, and the numbers of days of indwelling drainage tube in the external temporal muscle group were all less than those of the subtemporal muscle group（P 〈0.001） , incidence rate of subcutaneous hydrops was lower than that in the subtemporal muscle group（P 〈0.05）, and postoperative appearance satisfaction was higher than that of the subtemporal muscle group（P 〈0.01）.Difference of local pain incidence and improvement rate of skull defect syndrome was not statistically significant（ P 〉0.05）. Conclusion The digital forming titanium mesh repair with external temporal muscle for skull defect has obvious advantages like short operative time, less trauma, less intraoperative and postoperative bleeding.In ad- dition,it has little disturbance in temporal muscle injury and brain tissue with satisfactory appearance, the overall effect was better than that of repair of skull defect under temporal muscle.