数字化预制钛网成形修补额颞顶巨大颅骨缺损附20例报告.PDF

　 军 杂 20 13年9月1 日　第38卷　第9期 764 解放 医学 志　 论　著 数字化预制钛网成形修补额颞顶巨大颅骨缺损( 附2 0例报 告) 程钢戈，周岩，张晖，黄永安，董连强，马宏伟，张宝国 [摘要]　目的　探讨数字化预制钛网成形修补额颞顶巨大颅骨缺损的临床效果和手术技巧。方法　空军总医院 2006年11月－20 12年5月收治的巨大额颞顶颅骨缺损患者20例，男13例，女7例，年龄18 ～58岁，平均39岁，缺损大小 7.0cm ×9.0cm ～11.5cm ×14 .0cm ，平均8.5cm ×12.0cm 。患者均行头颅CT螺旋扫描，进行全颅骨数字化三维成像，根 据对称性原理描绘出缺损颅骨的形态和几何尺寸，输入数字化精密车床预制出边缘略大于(1.0 ～1.5cm)缺损尺寸的钛 网，剪边后得到最后的修复体。于去骨瓣术后6个月～1年行颅骨修补手术。结果　本组20例患者应用数字化钛网修补 额颞顶巨大颅骨缺损，钛网与缺损边缘颅骨严密贴合，塑形效果好，操作简单，手术时间明显缩短，术后外形美观、 对称，无并发症发生。结论　数字化钛网修补额颞顶巨大颅骨缺损明显优于传统术中手工塑形修补术，可提高患者生 活质量，值得临床推广。 [关键词]　数字化钛网；颅骨缺损；颅骨修补术 [中图分类号]　R683.5 [文献标志码]　A [文章编号]　0577-7402 (20 13)09-0764-03 Repair of large frontal temporal parietal skull defect with digitally reconstructed titanium mesh: a report of 20 cases CHENG Gang-ge, ZHOU Yan, ZHANG Hui, HUANG Yong-an, DONG Lian-qiang, MA Hong-wei, ZHANG Bao-guo Department of Neurosurgery, A ir Force General Hospital, Beijing 100 142, China [Abstract]　Objective　To ex pl ore th e clinical effect and surgical technique of th e repair of large defect inv olv ing frontal, temp oral, and parietal regions using digitally reconstructed titanium mesh . Methods　Tw enty patients w ith large frontal, temp oral, and parietal skull defect h ospitalized in A ir Force General Hospital from Nov emb er 2006 to May 20 12 w ere inv olv ed in this study. In th ese 20 p ati ents, th ere w ere 13 mal es and 7 f emal es, aged 18-58 y ears (m ean 39 y ears), and th e def ect size m easured from 7.0cm ×9.0cm to 11.5cm ×14 .0cm (mean 8.5cm ×12.0cm). Spiral CT h ead scan and digital three-dimensional reconstruction of skull w ere p erformed in all th e patients. Th e shap e and geometric size of skull defect w as traced based on th e sy mmetry principl e, and th en th e data w ere transferred into digital precision lath e to reconstruct a