儿童去骨瓣减压术后颅骨成形术的研究进展

Research progress of pediatric cranioplasty after decompressive craniectomy

去骨瓣减压术后因颅骨缺损往往需要行二期颅骨成形术。成人颅骨成形术在临床中已广泛应用,且技术成熟,疗效确切。儿童颅脑由于其特殊的生长发育特性,颅骨成形术相对于成人更具有挑战性:一方面,自体骨颅骨成形术有较高的骨吸收率,面临再次翻修的高风险;另一方面,儿童颅骨的动态生长特性限制了其异体材料的使用,且术后有一定的并发症风险。目前关于儿童颅骨成形术的文献报道相对较少,也尚无明确的指南来指导修补时间和修补材料的选择等。本文主要从儿童颅脑发育、术前颅骨缺损面积、修复材料、修复时间选择及其相关并发症等方面作一综述,分析和总结目前儿童颅骨成形术的研究现状,并为其临床诊疗和进一步探索提供方向。

After decompressive craniectomy,secondary cranioplasty is often required due to skull defects.Adult cranioplasty has been widely used in clinical practice,with mature technology and definite therapeutic effects.Due to its unique growth and developmental characteristics,cranioplasty in children is more challenging compared to adults.On the one hand,autologous bone cranioplasty has a higher bone absorption rate and faces a high risk of re revision;on the other hand,the dynamic growth characteristics of children's skulls limit the use of their allogeneic materials,and there is a certain risk of postoperative complications.At present,there are relatively few literature reports on pediatric cranioplasty,and there is no clear guide to guide the selection of repair time and materials.This article mainly reviews the development of children's brain,preoperative skull defect area,repair materials,repair time selection,and related complications.It analyzes and summarizes the current research status of pediatric cranioplasty,and provides direction for its clinical diagnosis,treatment,and further exploration.