数字化塑形钛网颅骨修复术临床与研究

发布时间：2018-12-27 17:48

【摘要】：研究目的:探讨数字化塑形钛网颅骨修复的优越性。研究方法:本研究收集颅面骨缺损患者均选用郴州市第一人民医院神经外科作者本人收治的颅面骨缺损患者40例,其中男性25例,女性15例;年龄18~65岁,平均41岁。其中19例患者利用数字化技术进行修补,术前行CT扫描,将所得二维数据由GEADW4.4工作站分别进行三维重建,并利用计算机辅助设计和计算机辅助制造技术,制造出个性化三维植入体,行个性化的颅面骨缺损的修补。将数字化钛网修补组,从手术时间,术中出血,术后并发症,术后外观满意度(从医生和患者双方评估满意度,术后医生评估双侧弧度是否对称,触摸是否移位,浮动及吸收塌陷,是否凹凸不平,术后复查影像学检查是否适配自体颅骨,患者自己照镜子对比双侧对称度,触摸是否凹凸不平)几方面与非数字化塑形钛网颅骨(组包括自体颅骨和人工塑形钛网)组对比。研究结果:结果应用数字化技术修复颅面骨缺损,对比非数字化塑形钛网颅骨(包括自体颅骨和人工塑形钛网)修复组,数字化技术修复颅面骨缺损组术后出现的并发症明显减少,术后只出现一例并发症(咀嚼痛),手术时间减少,术中出血明显减少。术后CT复查钛网与颅面骨适配度好。弧度适宜,双侧对称,修补后患者满意度高,将数字化技术运用到颅面骨的修复手术中,降低了手术后并发症发生率,手术时间减少,术中出血明显减少,提高了术后外观满意度。体现出其相关优越性。结论:本研究表明数字化钛网技术修补颅骨缺损不只是单纯恢复颅面骨外观,更有助于减少手术时间,术中出血量,减少并发症,增加术后外观满意度。
[Abstract]:Objective: to study the advantages of digital titanium mesh skull repair. Methods: 40 patients with craniofacial bone defect were selected from the neurosurgery department of the first people's Hospital of Chenzhou, including 25 males and 15 females, aged 1865 years, with an average age of 41 years. Among them, 19 patients were repaired by digital technique, CT scan was performed before operation, the 2D data were reconstructed by GEADW4.4 workstation, and computer aided design (CAD) and computer-aided manufacturing (CAM) were used. A personalized three-dimensional implant was made to repair the craniofacial bone defect. In the digital titanium mesh repair group, the surgical time, intraoperative bleeding, postoperative complications, postoperative appearance satisfaction were evaluated from both the doctor and the patient, and the doctor evaluated the bilateral radians symmetry and touch displacement after operation. Floating and absorbing collapse, whether it is uneven or not, whether the imaging examination after operation is suitable for the autogenous skull, the patient looks in the mirror and compares the bilateral symmetry, Whether the touch is uneven or not is compared with the non-digitized titanium mesh skull (including autogenous skull and artificial titanium mesh). Results: using digital technique to repair craniofacial bone defects, compared with non-digital titanium mesh skull repair group (including autogenous skull and artificial titanium mesh). In the group of repairing craniofacial bone defect by digital technique, the postoperative complications were significantly reduced, but only one case (masticatory pain) occurred after operation, the operation time was reduced, and the bleeding during operation was obviously reduced. After CT, the fit of titanium mesh and craniofacial bone was good. The application of digital technique to craniofacial bone repair can reduce the incidence of postoperative complications, reduce the operative time and decrease the bleeding during the operation. The postoperative appearance satisfaction was improved. It reflects its relative superiority. Conclusion: this study shows that the repair of skull defects with digital titanium mesh is not only to restore the appearance of craniofacial bone, but also to reduce the operation time, blood loss, complications and postoperative appearance satisfaction.
【学位授予单位】：南华大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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