数字化塑型钛网颅骨修补手术时机对术后并发症的影响分析

Analysis of complications on the surgical timing of cranioplasty with digital forming titanium plate

目的探讨三维数字化塑形钛网颅骨修补手术时机对术后并发症的影响及防治措施。方法对本院138例应用三维数字化塑型钛网行颅骨缺损修补术患者进行回顾性分析,根据颅骨修补手术时机分为常规组(2~6)个月和晚期组(>6个月),术后随访(1~5)年,对两组术后并发症进行观察比较。结果术后并发症有切口裂开、皮下积液、颅内血肿、癫痫、钛网外露。合计并发症发生率常规组15.38%,晚期组23.40%,差异无统计学意义(P>0.05)。其中切口裂开、皮下积液、颅内血肿、新发癫痫发生率两组比较差异无统计学意义(P>0.05)。钛网外露发生率两组比较差异具有统计学意义(P<0.05),晚期组高于常规组。结论延迟修补不能减少术后并发症的发生,甚至会导致钛网外露等一些难治并发症增多。在条件允许的情况下,应尽早行颅骨缺损修补。

Objective To explore the influence of postoperative complications on the surgical timing of cranioplasty with digital forming titanium plate and the prevention and treatment measures.Methods A retrospective analysis was conducted on 138 cases of patientswho underwent cranioplastywith digital forming titanium plate in our hospital.According to the timing of skull repair surgery,the patientswere divided into two groups:the conventional group(2-6months)and the advanced group(>6months)and followed up for 1-5 years.The postoperative complications of the two groups were observed and compared.Results Postoperative complications included incision dehiscence,subcutaneous effusion,intracranial hematoma,epilepsy and titanium mesh exposure.The incidence of complications was 15.38%in the routine group and 23.40%in the advanced group,with no statistically significant difference(P>0.05).The incidences of incisional dehiscence,subcutaneous hydrops,intracranial hematoma and new-onset epilepsy were not statistically significant(P>0.05).The incidence of titanium mesh exposure was significantly higher in the late group than that of the conventional group(P<0.05).Conclusion Delayed repair cannot reduce the occurrence of postoperative complications,and may even lead to the increase of some refractory complications such as titaniummesh exposure.If conditions permit,skull defect repair should be carried out as soon as possible.