颅骨缺损钛网修补的常见问题及处理

Common Problems and Treatment of Titanium Mesh Repair of Skull Defect

目的探讨颅骨缺损钛网修补过程中常见的问题、防治方法及效果。方法对2009年1月—2015年12月该院收治的146例颅骨缺损行钛网修补患者进行1个月-1年的随访,对钛网修补过程中出现常见问题的40例患者的临床资料回顾性分析。结果该组40例出现常见问题的患者包括：外形效果差、影响美观10例,术前骨窗塌陷或膨出10例,头皮下积血、积液3例,硬膜下血肿、脑挫裂伤1例,咬合疼痛6例,切口愈合不良、头皮坏死2例,切口感染2例,癫痫3例,钛网外露3例。结论颅骨缺损钛网修补虽然手术操作简单,但对于出现的常见问题应予足够的重视,通过正确的术前评估、改进手术方法、提高手术技巧、采取相应的预防性措施可以降低相关问题的发生,提高手术的成功率。

Objective To investigate the common problems, prevention and treatment methods and results of the titanium mesh repair of the skull defect. Methods Treated in our hospital in January 2009 to December 2015, 146 cases of skull defect, titanium mesh in the repair of patients were followed up for 1 month to 1 year, of titanium mesh in the repair process appears the clinical data of 40 patients with common problems were analyzed retrospectively. Results This group of 40 cases of patients with common problems include： shape effect difference, affect the appearance of 10 cases, preoperative bone window collapse or bulging in 10 cases, scalp product blood and effusion in 3 cases, subdural hematoma, cerebral contusion and laceration in 1 cases, occlusal pain in 6 cases, wound healing, scalp necrosis in 2 cases, incision infection in 2 cases, 3cases of epilepsy, exposure of titanium mesh in 3 cases. Conclusion Skull defect with titanium mesh repair, although the operation is simple, but for the common problems should be enough attention, through the correct preoperative evaluation,improvement of surgical methods, improve surgical skills, to take corresponding preventive measures can reduce the related problems and improve success rate of the operation of the high.