• 中山大學(xué)孫逸仙紀(jì)念醫(yī)院神經(jīng)外科（廣州，510120）;

目的 觀察可吸收固定系統(tǒng)對開顱游離骨瓣復(fù)位的固定效果及不良反應(yīng)。 方法2010年7月－2011年12月，對67例開顱游離骨瓣成型切除顱內(nèi)病變后患者，采用可吸收固定系統(tǒng)進(jìn)行骨瓣復(fù)位固定。其中男38例，女29例；年齡5個月～73歲，中位年齡32歲。病程3個月～6年，中位病程25個月。幕上病變41例，幕下病變26例；其中位于額顳部13例，額頂部12例，顳頂部8例，顳枕部5例，頂枕部4例，后顱窩25例。診斷為膠質(zhì)瘤15例，腦血管性疾?。▌用}瘤、動靜脈畸形及海綿狀血管瘤）8例，腦膜瘤和蛛網(wǎng)膜囊腫各7例，聽神經(jīng)瘤和原發(fā)三叉神經(jīng)痛各5例，膽脂瘤和腦膿腫各3例，垂體瘤、顱咽管瘤、轉(zhuǎn)移瘤及放射性腦病各2例，髓母細(xì)胞瘤、室管膜瘤、生殖細(xì)胞瘤、非典型畸胎瘤/橫紋肌樣瘤、面肌痙攣及硬膜下血腫各1例。顱內(nèi)病變范圍3 cm × 2 cm～7 cm × 5 cm。觀察術(shù)后局部切口及全身情況變化。 結(jié)果術(shù)后有2例幕上和3例幕下病變患者少許皮下積液，均經(jīng)穿刺抽吸2周后消失；術(shù)后切口均Ⅰ期愈合，無紅腫、發(fā)熱等表現(xiàn)；術(shù)后2周內(nèi)復(fù)查CT或MRI示骨瓣復(fù)位良好，內(nèi)、外顱骨面均平整，無任何影像偽影。67例均獲隨訪，隨訪時間3～20個月，平均10.3個月。切口無不適，頭顱外觀正常，無局部凹陷、積液等。CT或MRI復(fù)查未見骨瓣移位凹陷及偽影。 結(jié)論應(yīng)用可吸收固定系統(tǒng)進(jìn)行骨瓣復(fù)位固定簡便、安全、可靠，且能消除術(shù)后CT或MRI復(fù)查時金屬固定材料導(dǎo)致的偽影，近期療效較好。

引用本文： 鄧躍飛,鄭眉光,吳錦銓. 可吸收固定系統(tǒng)在開顱骨瓣復(fù)位固定手術(shù)中的初步應(yīng)用. 中國修復(fù)重建外科雜志, 2012, 26(10): 1202-1205. doi: 復(fù)制

1. 鄧躍飛, 趙義營, 張錦祥, 等. 經(jīng)小腦延髓裂入路顯微手術(shù)治療兒童第四腦室腫瘤. 中華小兒外科雜志, 2012, 33(1): 9-12.
2. 魯祥和, 鄭偉明, 吳近森, 等. 枕下骨瓣開顱術(shù)治療后顱窩病變. 中華神經(jīng)外科雜志, 2006, 22(10): 609-611.
3. 祁磊, 王茂德. 顱骨骨瓣內(nèi)固定技術(shù)應(yīng)用現(xiàn)況及進(jìn)展. 中華神經(jīng)醫(yī)學(xué)雜志, 2010, 9(3): 322-324.
4. 陳政剛, 周建, 楊堃, 等. 骨瓣復(fù)位成形術(shù)與咬骨窗術(shù)在后顱窩手術(shù)中的病例對照研究. 現(xiàn)代預(yù)防醫(yī)學(xué), 2011, 38(9): 1786-1789.
5. 楊樹旭, 王義榮, 蘇志鵬. 回復(fù)固定顱骨骨折骨瓣模型的比較研究. 中華創(chuàng)傷雜志, 2004, 20(4): 246-247.
6. 趙衛(wèi)忠, 朱明霞, 高覺, 等. 顱骨固定釘在顱骨修補(bǔ)術(shù)中的應(yīng)用. 中華神經(jīng)醫(yī)學(xué)雜志, 2005, 4(3): 290-291.
7. Winston KR, Wang MC. Cranial bone fixation: review of the literature and description of a new procedure. J Neurosurg, 2003, 99(3): 484-488.
8. Broaddus WC, Holloway KL, Winters CJ, et al. Titanium miniplates or stainless steel wire for cranial fixation: a prospective randomized comparison. J Neurosurg, 2002, 96(2): 244-247.
9. Yang YM, Chen XM, Ding F, et al. Biocompatibility evaluation of silk fibroin with peripheral nerve tissues and ceils in vitro. Biomaterials, 2007, 28(9): 1643-1652.
10. Hollander DA, von Waiter M, Wirtz T, et al. Structural, mechanical and in vitro characterization of individually structured Ti-6Al-4V produced by direct laser forming. Biomaterials, 2006, 27(7): 955-963.
11. Gordon PN, Komegay JN, Lattimer JC, et al. Use of a rivet-like titanium clamp closure system to replace an external frontal bone flap after transfrontal craniotomy in a dog. J Am Vet Med Assoe, 2005, 226(5): 752-754．.
12. Kovács AF, Sauer SN, Stefenelli U, et al. Growth of the orbit after frontoorbital advancement using nonrigid suture vs rigid plate fixation technique. J Pediatr Surg, 2008, 43(11): 2075-2081.
13. Brasileiro BF, Grempel RG, Ambrosano GM, et al. An in vitro evaluation of rigid internal fixation techniques for sagittal split ramus osteotomies: advancement surgery. J Oral Maxillofac Surg, 2009, 67(4): 809-817.
14. Uckan S, Bayram B, Keeik D, et al. Effect of titasnium plate fixation on mandibular growth in a rabbit model. J Oral Maxillofac Surg, 2009, 67(2): 318-222.
15. Lazennec JY, Madi A, Rousseau MA, et al. Evaluation of the 96/4PLDLLA polymer resorbable lumbar interbody cage in a long term animal model. Eur Spine J, 2006, 15(10): 1545-1553.
16. Shellock FG. Excessive temperature increases in pacemaker leads 3-TMR imaging with a transmit-receive head coil. Radiology, 2009, 251(3): 948-949.
17. Esen A, Atao?lu H, Gemi L. Comparison of stability of titanium and absorbable plate and screw fixation for mandibular angle fractures. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2008, 106(6): 806-811.
18. Dhol WS, Reyneke JP, Tompson B, et al. Comparison of titanium and resorbable copolymer fixation after Le Fort I maxillary impaction. Am J Orthod Dentofacial Orthop, 2008, 134(1): 67-73.
  1. 1. 鄧躍飛, 趙義營, 張錦祥, 等. 經(jīng)小腦延髓裂入路顯微手術(shù)治療兒童第四腦室腫瘤. 中華小兒外科雜志, 2012, 33(1): 9-12.
  2. 2. 魯祥和, 鄭偉明, 吳近森, 等. 枕下骨瓣開顱術(shù)治療后顱窩病變. 中華神經(jīng)外科雜志, 2006, 22(10): 609-611.
  3. 3. 祁磊, 王茂德. 顱骨骨瓣內(nèi)固定技術(shù)應(yīng)用現(xiàn)況及進(jìn)展. 中華神經(jīng)醫(yī)學(xué)雜志, 2010, 9(3): 322-324.
  4. 4. 陳政剛, 周建, 楊堃, 等. 骨瓣復(fù)位成形術(shù)與咬骨窗術(shù)在后顱窩手術(shù)中的病例對照研究. 現(xiàn)代預(yù)防醫(yī)學(xué), 2011, 38(9): 1786-1789.
  5. 5. 楊樹旭, 王義榮, 蘇志鵬. 回復(fù)固定顱骨骨折骨瓣模型的比較研究. 中華創(chuàng)傷雜志, 2004, 20(4): 246-247.
  6. 6. 趙衛(wèi)忠, 朱明霞, 高覺, 等. 顱骨固定釘在顱骨修補(bǔ)術(shù)中的應(yīng)用. 中華神經(jīng)醫(yī)學(xué)雜志, 2005, 4(3): 290-291.
  7. 7. Winston KR, Wang MC. Cranial bone fixation: review of the literature and description of a new procedure. J Neurosurg, 2003, 99(3): 484-488.
  8. 8. Broaddus WC, Holloway KL, Winters CJ, et al. Titanium miniplates or stainless steel wire for cranial fixation: a prospective randomized comparison. J Neurosurg, 2002, 96(2): 244-247.
  9. 9. Yang YM, Chen XM, Ding F, et al. Biocompatibility evaluation of silk fibroin with peripheral nerve tissues and ceils in vitro. Biomaterials, 2007, 28(9): 1643-1652.
  10. 10. Hollander DA, von Waiter M, Wirtz T, et al. Structural, mechanical and in vitro characterization of individually structured Ti-6Al-4V produced by direct laser forming. Biomaterials, 2006, 27(7): 955-963.
  11. 11. Gordon PN, Komegay JN, Lattimer JC, et al. Use of a rivet-like titanium clamp closure system to replace an external frontal bone flap after transfrontal craniotomy in a dog. J Am Vet Med Assoe, 2005, 226(5): 752-754．.
  12. 12. Kovács AF, Sauer SN, Stefenelli U, et al. Growth of the orbit after frontoorbital advancement using nonrigid suture vs rigid plate fixation technique. J Pediatr Surg, 2008, 43(11): 2075-2081.
  13. 13. Brasileiro BF, Grempel RG, Ambrosano GM, et al. An in vitro evaluation of rigid internal fixation techniques for sagittal split ramus osteotomies: advancement surgery. J Oral Maxillofac Surg, 2009, 67(4): 809-817.
  14. 14. Uckan S, Bayram B, Keeik D, et al. Effect of titasnium plate fixation on mandibular growth in a rabbit model. J Oral Maxillofac Surg, 2009, 67(2): 318-222.
  15. 15. Lazennec JY, Madi A, Rousseau MA, et al. Evaluation of the 96/4PLDLLA polymer resorbable lumbar interbody cage in a long term animal model. Eur Spine J, 2006, 15(10): 1545-1553.
  16. 16. Shellock FG. Excessive temperature increases in pacemaker leads 3-TMR imaging with a transmit-receive head coil. Radiology, 2009, 251(3): 948-949.
  17. 17. Esen A, Atao?lu H, Gemi L. Comparison of stability of titanium and absorbable plate and screw fixation for mandibular angle fractures. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2008, 106(6): 806-811.
  18. 18. Dhol WS, Reyneke JP, Tompson B, et al. Comparison of titanium and resorbable copolymer fixation after Le Fort I maxillary impaction. Am J Orthod Dentofacial Orthop, 2008, 134(1): 67-73.