天津医药

天津医药 ›› 2017, Vol. 45 ›› Issue (8): 806-808.doi: 10.11958/20170653

• 专题 颅脑神经创伤 • 上一篇    下一篇

以聚醚醚酮植入体行颅骨缺损成形术的初步研究

张国斌 1， 张述升 1， 靳峥 1， 陈悦达 1， 张昕 1， 王修玉 2， 李家林 1， 王均伟 1， 刘琳 1， 王民 1， 关莹 3， 倪涛 3   

  1. 1 天津市环湖医院神经外科， 天津市脑血管病与神经变性重点实验室 （邮编 300350）； 2 天津市第一中心医院神经外科； 3 天津 市环湖医院手术室
  • 收稿日期:2017-06-09 修回日期:2017-07-14 出版日期:2017-08-15 发布日期:2017-08-15
  • 通讯作者: 张国斌 （1970）， 男， 博士， 副主任医师， 主要从事颅脑创伤与神经重症相关的临床治疗以及基础研究 E-mail:cntjzgb@hotmail.com
  • 作者简介:张国斌 （1970）， 男， 博士， 副主任医师， 主要从事颅脑创伤与神经重症相关的临床治疗以及基础研究

Preliminary study on polyetheretherketone implant applied to cranioplasty of skull defect

ZHANG Guo-bin1, ZHANG Shu-sheng1, JIN Zheng1, CHEN Yue-da1, ZHANG Xin1, WANG Xiu-yu2, LI Jia-lin1, WANG Jun-wei1, LIU Lin1, WANG Min1, GUAN Ying3, NI Tao3   

  1. 1 Department of Neurosurgery, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Tianjin 300350, China; 2 Department of Neurosurgery, Tianjin First Central Hospital; 3 Department of Operating Center, Tianjin Huanhu Hospital
  • Received:2017-06-09 Revised:2017-07-14 Published:2017-08-15 Online:2017-08-15

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摘要： 目的 研究以聚醚醚酮 （PEEK） 植入体行颅骨成形术的操作方法、 安全性及治疗效果。方法 选取单侧手 术后颅骨缺损 6 个月以上患者 11 例（男 10 例， 女 1 例）， 均依据各自颅骨成形术前的颅骨 1 mm 精扫 CT 数据行 PEEK 植入体数字化三维加工定制， 在经高压灭菌后于全麻下行手术修补颅骨缺损； 检查、 对比手术前/后影像学资 料， 记录患者生命体征变化及术后 2 周、 3 个月以及 1 年随访结果。结果 全部患者伤口均Ⅰ/甲愈合， 术后感觉无 异常， 5 例出现一过性皮瓣下积液后经穿刺消失， 1 例因拔除皮瓣下引流管后出血而急诊再行血肿清除、 植入体原位 保留、 伤口一期缝合， 患者主观感受与外在感观均良好， 术后 CT 与磁共振检查未发现伪影干扰， 未出现中枢神经系 统以及全身其他器官的新发功能障碍， 无其他远期并发症出现。结论 以 PEEK 植入体行颅骨成形术的方法可行、 操作上未增加困难、 疗效安全可靠。对于有经济基础且针对某些成形术后情况存在特殊要求的患者， PEEK 不失为 一种理想的备选修补材料。

关键词: 假体植入, 聚醚醚酮, 颅骨缺损, 颅骨成形术

Abstract: Objective To study on the procedure, safety and effectiveness of polyetheretherketone (PEEK) implant applied to cranioplasty of skull defect. Methods A total of 11 cases (10 male, 1 female) of unilateral skull defect, more than 6 months post operation, were included in this study. PEEK implant was custom- made by three- dimensional numerically controlled processing depended on the data obtained from 1 mm-slice CT scan before cranioplasty individually. Autoclaved implants were applied to cranioplastic surgeries under general anesthesia. Findings of imaging examination and vital signs were compared before and after operation. Vital sign changes and circumstances during procedure were noted, and following- up reviews were performed on 2- week, 3- month and 1 year after operation respectively. Results Wounds healing were uneventful in 11 cases, no postoperative paresthesia presented. Surgical complications including temporary subcutaneous exudates were cleared up by puncture and aspiration in 5 cases, subcutaneous hematoma duo to drainage removal in 1 case, of which an emergency evacuation was performed and the implant was still with instant incision closure and then smooth recovery eventually. No significant abnormal fluctuation of laboratory examination was reported, moreover no artifact interference was found on postoperative CT scan or MR image. The subjective feelings and external sensory effects are satisfactory in patients. No emerging dysfunction of central nervous system or other organs was found, and no long-term complication was appeared. Conclusion It is feasible and safe to apply PEEK implant to cranioplasty without additional operative difficulty. This kind of material is an ideal alternative for repairing skull defect to patients with good financial condition and specific demands for postoperative status especially.

Key words: prosthesis implantation, polyetheretherketone, skull defect, cranioplasty