[1]阿木约布 王俊勇 廉坤 徐蔚.颅骨成形术后钛网外露原因分析及防治[J].中国临床神经外科杂志,2017,(10):698-700.[doi:10.13792017.09/j.issn.1009-153X.2017.10.009]
　AMU Yue-bu,WANG Jun-yong,LIAN Kun,et al.Analysis of cause and prevention of titanium mesh exposure after digital cranioplasty[J].,2017,(10):698-700.[doi:10.13792017.09/j.issn.1009-153X.2017.10.009]
点击复制

颅骨成形术后钛网外露原因分析及防治()
分享到：

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2017年10期
页码:
698-700
栏目:
论著
出版日期:
2017-10-25

文章信息/Info

Title:
Analysis of cause and prevention of titanium mesh exposure after digital cranioplasty
文章编号:
1009-153X（2017）10-0698-03
作者:
阿木约布 王俊勇 廉坤 徐蔚
650101 昆明，昆明医科大学第二附属医院神经外科
Author(s):
AMU Yue-bu;  WANG Jun-yong;  LIAN Kun;  XU Wei.
Department of Neurosurgery, The Second Affiliated Hospital, Kunming MedicalCollege, Kunming 650101, China
关键词:
颅骨成形术; 数字化成形钛网; 钛网外露; 治疗
Keywords:
Cranial defect;  Cranioplasty;  Titanium meshes;  Exposure
分类号:
R 651.1+1
DOI:
10.13792017.09/j.issn.1009-153X.2017.10.009
文献标志码:
A
摘要:
目的探讨以数字化成形钛网行颅骨缺损成形术后钛网外露原因及防治方法。方法回顾性分析自2011年7月至2016年6月收治的12例利用数字化成形钛网行颅骨成形术后钛网外露的临床资料。结果钛网外露创口宽径≤3 cm 7例中，3例经二次清创缝合或二次清创+皮瓣转移术后恢复；4例二次清创缝合后或二次清创+皮瓣转移后1个月仍出现化脓迁延不愈，行钛网取出术，经二次成形术后恢复。外露创口宽径>3 cm的5例行钛网取出术，经二次成形术后恢复。结论对于钛网外露、露口反复出现化脓者，尽早行钛网取出术。规范化的手术及术后管理，出院后健康宣教，可最大程度避免钛网外露。
Abstract:
Objective To explore the cause of titanium mesh exposure after digital cranioplasty and methods to prevent it.Method The clinical data of 12 patients with titanium mesh exposure after digital cranioplasty from July, 2011 to June, 2016 wereanalyzed retrospectively. Results The exposed titanium mesh had a maximum diameter of less than 3 cm in 7 patients and of more than 3cm in 5 patients. Of 7 patients with exposed titanium meshes less than 3 cm in the maximum diameter, 3 were cured and 4 not after thesecond debridement and skin flap transferring. Five patients with exposed titanium meshes more than 3 cm in the maximum diameterwere cured after the removal of the titanium meshes and the second cranioplasty. Conclusions The exposed titanium mesh should beextracted as early as possible in the patient with exposed titanium mesh associated with festering. The adequate preoperative preparation,favorable surgical technique and proper health education after discharge from hospital are important to minimization of titanium meshesexposure after digital cranioplasty in the patients with cranial defect.

参考文献/References:

[1] 江基尧. 颅脑创伤临床救治指南[M]. 第四版. 上海第二军医大学出版社，2015. 278-284.
[2] 尹成，钱忠心. 颅骨修补术后对脑血流及神经功能影响的研究进展[J]. 临床神经外科杂志，2013，10：186-188.
[3] 张猛，邵柏，颜庆华，等. 颅骨修补钛网外露[J]. 临床神经外科杂志，2014，11（4）：301-302.
[4] 罗东，林艳美，梁永艺，等. 数字化成形钛网修补额颞部颅骨缺损45 例临床分析[J]. 中国实用神经疾病杂志，2015，18（14）：96-97.
[5] 丁振荣，刘汉华，杨华，等. 三维钛网修补颅骨缺损并发症的原因探讨[J]. 中国临床神经外科杂志，2011，16（2)：87-88.
[6] Xu H, Niu C, Fu X, et al. Early cranioplasty vs. late cranioplastyfor the treatment of cranial defect: a systematic review[J]. Clin Neurol Neurosurg, 2015, 136: 33-40.
[7] Wen L, Lou HY, Xu J, et al. The impact of cranioplasty oncerebral blood perfusion in patients treated with decompressivecraniectomy for severe traumatic brain injury [J].Brain Inj, 2015, 29(13-14): 1654-1660.
[8] Son J, Liu M, Mo X, et al. Benifical impact of early cranioplastyin patients with decompressive craniectomy: evidencefrom transcrania Doppler ultrasonography [J]. Acta Neurochir(Wien), 2014, 156(1): 193-198.
[9] Schmidek HH. 神经外科手术学[M].第四版. 王仁直译. 北京：人民卫生出版社，2003. 27-37.
[10] Lee CH, Chung YS, Lee SH, et al. Analysis of the factorsinfluencing bone graft infection after cranioplasty [J]. JTrauma Acute Care Surg, 2012, 73(1): 255-260.
[11] 中华神经外科学会神经创伤专业组. 创伤性颅骨缺损中国专家共识[J]. 中华神经外科杂志，2016，32：768-770.
[12] Cheng YK, Weng HH, Yang JT, et al. Factors affecting graftinfection after cranioplasty [J]. J Clin Neurosci, 2008, 15(10): 1115-1119.
[13] Matsuno A, Tanaka H, Iwamuro H, et al. Analyses of thefactors influencing bone graft infection after delayed cranioplasty[J]. Acta Neurochir (Wien), 2006, 148(5): 535-540.

相似文献/References:

[1]吴广源　尹　卫　郑思阳　齐　辉.自体颅骨碎屑一期修复颅神经微血管减压术骨窗的临床观察[J].中国临床神经外科杂志,2015,(06):364.[doi:10.13798/j.issn.1009-153X.2015.06.016]
[2]任瑞明　成文平　李会兵　申彦杰　朱金钊　张　坤　程东亮　楚鹏飞.颅脑损伤去骨瓣减压术后超早期颅骨成形术的疗效分析[J].中国临床神经外科杂志,2016,(08):471.[doi:10.13798/j.issn.1009-153X.2016.08.009]
　REN Rui-ming,CHENG Wen-ping,LI Hui-bing,et al.Curative effect of cranioplasty ultra-early after decompressive craniectomy on patients with severe traumatic brain injury[J].,2016,(10):471.[doi:10.13798/j.issn.1009-153X.2016.08.009]
[3]王志明,殷尚炯,曹藏柱,等.塑形钛网颅骨成形术后并发症的原因及防治[J].中国临床神经外科杂志,2016,(11):698.[doi:10.13798/j.issn.1009-153X.2016.11.015]
[4]王志明　孟文博　程月飞　曹藏柱　黄立超　季晓军.塑形钛网修补双额部无骨桥大面积颅骨缺损9例[J].中国临床神经外科杂志,2017,(01):44.[doi:10.13798/j.issn.1009-153X.2017.01.017]
[5]陈　浪　严正村　佘　磊　董　伦　张恒柱　王晓东　魏　民　王杏东.脑室-腹腔分流术联合颅骨成形术治疗颅脑损伤去骨板减压术后脑积水[J].中国临床神经外科杂志,2017,(08):593.[doi:10.13798/j.issn.1009-153X.2017.08.026]
[6]陈　俊　周赤忠　刘　融.颅骨修补材料运用现状及3D打印技术在其制备工艺中的应用展望[J].中国临床神经外科杂志,2017,(08):597.[doi:10.13798/j.issn.1009-153X.2017.08.004]
[7]罗　飞　王文浩　林　洪　胡连水　李　君　林俊明　黄　巍.粉碎性颅骨骨折合并硬膜外血肿的手术处理[J].中国临床神经外科杂志,2017,(09):658.[doi:10.13792017.09/j.issn.1009-153X.2017.09.018]
[8]桂志勇 杨明 叶党华 黄俊红 王群涛 赵晓生 白敬洋.颞肌成形在颅骨成形术中的临床应用[J].中国临床神经外科杂志,2017,(10):701.[doi:10.13792017.09/j.issn.1009-153X.2017.10.010]
　GUI Zhi-yong,YANG Ming,YE Dang-hua,et al.Clinical application of temporalis myoplasty during cranioplasty in patients with cranial defects[J].,2017,(10):701.[doi:10.13792017.09/j.issn.1009-153X.2017.10.010]
[9]丁伟龙　王向宇　王晓东.颞肌外与颞肌下颅骨成形术疗效的Meta分析[J].中国临床神经外科杂志,2018,(02):90.
　DING Wei-long,WANG Xiang-yu,WANG Xiao-dong..Outside temporalis versus under temporalis for cranioplasty: a meta-analysis of curative effects[J].,2018,(10):90.
[10]孙玉晨　出良钊　董明昊　冯鲁乾　刘　健　钟　钰.聚醚醚酮与钛网在颅骨成形术中应用体会[J].中国临床神经外科杂志,2018,(02):103.

备注/Memo

备注/Memo:
基金项目：云南省应用基础研究-昆医联合专项（2014FB054）作者单位：650101 昆明，昆明医科大学第二附属医院神经外科（阿木约布、王俊勇、廉坤、徐蔚）通迅作者：徐蔚，E-mail：657265075@qq.com
更新日期/Last Update: 1900-01-01