摘要
目的 探讨体外深低温保存钴-60灭菌自体颅骨瓣修补颅骨缺损的临床应用价值。方法 回顾性分析2022年1月-2023年9月在安庆市立医院神经外科行颅骨修补术的83例患者的临床资料,其中选择自体颅骨瓣修补的42例为研究组,三维钛网修补的41例为对照组。对两组的围手术期指标、相关并发症、手术前后神经功能及健康状况、术后6个月修补失败率和满意度进行统计分析。结果 研究组手术时长、术中出血量、手术相关并发症(癫痫、感染、出血、切口愈合不良、皮下积液)总体发生率与对照组相比,差异均无统计学意义(P>0.05)。自体颅骨组的住院时间、住院费用显著优于钛网组(P<0.05),随访6个月,研究组无骨瓣吸收和感染病例,对照组钛网外露1例需取出修补材料,修复失败率无显著差异(P>0.05)。两组患者术后6个月格拉斯哥预后量表(GOS)评分和Karnofsky功能状态(KPS)评分均较术前升高,差异有统计学意义(P<0.05)。两组患者满意度方面(外观不对称、气温变化敏感、头部不适、行核磁检查受影响、颅骨变形或凹陷、焦虑)的差异有统计学意义(P<0.05)。结论 体外深低温保存钴-60灭菌自体颅骨和定制三维钛网在颅骨缺损修补术中的应用效果均较好,但自体颅骨修补更容易被患者接受,术后满意度更高,是一种简便、经济、安全、有效的方法。
Objective To investigate the clinical value of in vitro deep hypothermic preservation of cobalt-60 sterilized autologous skull flaps for skull defect repair.Methods The clinical data of 83 patients who underwent skull defect repair in Department of Neurosurgery,Anqing Municipal Hospital from January 2022 to September 2023 were analyzed retrospectively,of which 42 patients who underwent autologous skull flap repair were selected as the study group,41 cases with three-dimensional titanium mesh repair were the control group.Perioperative indexes,related complications,neurological function and health status before and after operation,repair failure rate and satisfaction rate in 6 months after operation were statistically analyzed in the two groups.Results There was no significant difference in the operative duration,amount of intraoperative bleeding,overall incidence of operative related complications(epilepsy,infection,bleeding,poor wound healing,subcutaneous effusion)between the study group and the control group(P>0.05).The hospitalization time and hospitalization cost in autogenous bone group were significantly better than those in titanium mesh group(P<0.05).There was no bone flap resorption and infection in the study group,and one case with titanium mesh exposure in the control group needed to remove the repair material.There was no significant difference in the repair failure rate(P>0.05).Glasgow outcome scale(GOS)and Karnofsky performance status(KPS)scores were significantly higher in the two groups at 6 months after operation(P<0.05).There were significant differences between the two groups in terms of satisfaction(asymmetrical appearance,sensitive to air temperature,head discomfort,affected when performing magnetic resonance imaging,skull deformation or depression,anxiety)(P<0.05).Conclusions In vitro deep hypothermic preservation of cobalt-60 sterilized autologous skull flaps and customized three-dimensional titanium mesh are both effective in cranial defect repair,but autologous skull repair is easier to b
作者
张清超
查正江
李志宏
周和平
李建
ZHANG Qingchao;ZHA Zhengjiang;LI Zhihong;ZHOU Heping;LI Jian(Department of Neurosurgery,Anqing Municipal Hospital,Anqing 246003,China)
出处
《临床神经外科杂志》
2024年第6期648-653,共6页
Journal of Clinical Neurosurgery
基金
安徽省科技重大专项项目(201903a07020006)
安徽省重点研究与开发计划项目(2022e07020052)
安徽医科大学附属安庆医学中心自然科学项目(2022aqykj03)。
关键词
自体颅骨
深低温
钴-60灭菌
颅骨修补手术
autologous skull flap
deep hypothermia
cobalt-60 sterilization
skull repair operation
