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目的探讨计算机三维塑形钛网板早期修补颅骨缺损的疗效。方法选择36例颅骨缺损病人,术前利用CT进行头颅扫描取得颅骨及缺损部位的三维几何模型数据,利用计算机进行颅骨三维重建制作颅骨缺损的原始模型,根据模型缺损的面积、弧度设计出塑形计划,利用数字化设备对钛网板进行精确的塑形剪切,术中将钛网板根据解剖结构固定于缺损部位。结果36例患者中,34例患者切口一期愈合,2例出现皮下积液(经皮下穿刺抽液后消失)。17例患者术前有不同程度的智能障碍,术后14例智能障碍明显改善。所有病例修补后头颅对称,外形良好基本恢复了原始状态。结论去骨瓣减压后4至12周进行计算机三维塑形钛网板颅骨修补是可行的,早期修补效果较延期修补好,应用计算机三维塑形钛网板早期修补颅骨缺损值得推广。
Objective To investigate the curative effect of early repairing skull defect with computerized three-dimensional titanium mesh plate. Methods Thirty-six patients with skull defects were selected. Three-dimensional geometric model data of skull and defect site were obtained by CT scan before operation. Three-dimensional reconstruction of cranium was performed by computer to make the original model of skull defect. The model was designed according to the area and curvature of model defects Plan, the use of digital equipment for accurate shaping titanium plate cut, intraoperative titanium mesh plate fixed to the defect site based on anatomical structure. Results Among the 36 patients, 34 patients underwent incision healing in one period and subcutaneous fluid effusion in 2 patients (disappeared after subcutaneous puncture and aspiration). Seventeen patients had different levels of preoperative intelligence disorder, and 14 cases of postoperative intelligence disorders improved significantly. After repair all cases of cranial symmetry, good shape basically restored the original state. Conclusion It is feasible to reconstruct craniofacial calcaneal titanium mesh plates 4 to 12 weeks after decompressive craniotomy. The early repairing effect is better than the delayed repairing. It is worth to popularize cranial defects repaired with computerized three-dimensional titanium mesh plate in the early stage.